Organization Active NPI

Park Avenue Pharmacy, Inc

Doing business as dba PARK AVENUE PHARMACY LTC

  • Community/Retail Pharmacy
  • Chambersburg, PA
National Provider Identifier
1134124274
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP411765L Issued in PA
Legal business name
PARK AVENUE PHARMACY, INC
Doing business as
dba PARK AVENUE PHARMACY LTC
Practice address
220 Park Ave
Chambersburg, PA 17201-1230
Phone
(717) 264-7312
Fax
(717) 264-3751
NPI assigned
Jun 16, 2005
Last updated
Dec 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dawn L Naugle
Title
Book Keeper
Phone
(717) 264-6652

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X NU
Community/Retail Pharmacy 3336C0003X PP411765L PA Primary

Addresses

Primary practice location

220 Park Ave
Chambersburg, PA 17201-1230

Mailing address

220 Park Ave
Chambersburg, PA 17201-1230
Phone (717) 264-7312

Other identifiers 1

IdentifierTypeStateIssuer
1018904570001MedicaidPA

Other names 1

  • dba PARK AVENUE PHARMACY LTC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930058273 PA DME Supplier - Pharmacy 5890812549 Practice locations: Chambersburg, PA
O20131125001001 PA Part B Supplier - Mass Immunization (Roster Biller Only) 5890812549 Practice locations: Chambersburg, PA

National Provider Directory

National Provider Directory
Tax ID family
Park Avenue Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

220 Park Ave
Chambersburg, PA 17201
Phone (717) 264-7312

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1134124274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 PARK AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011230",
            "telephone_number": "717-264-7312",
            "fax_number": "717-264-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 PARK AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011230",
            "telephone_number": "717-264-7312",
            "fax_number": "717-264-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "NAUGLE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BOOK KEEPER",
        "authorized_official_telephone_number": "717-264-6652"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP411765L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018904570001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba PARK AVENUE PHARMACY LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chambersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.