NPIMap

Organization Active NPI

Weis Markets Inc

Doing business as Weis Pharmacy #121

  • Community/Retail Pharmacy
  • Charlotte Hall, MD
National Provider Identifier
1154218279
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WEIS MARKETS INC
Doing business as
Weis Pharmacy #121
Practice address
30015 Three Notch Rd
Charlotte Hall, MD 20622-4120
Phone
(301) 905-0964
NPI assigned
Jun 20, 2025
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Mr. Nicholas J. Cicco, PHARM D
Title
Vice President, Pharmacy
Phone
(570) 286-3201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

30015 Three Notch Rd
Charlotte Hall, MD 20622-4120

Mailing address

PO Box 471
Sunbury, PA 17801-0471
Phone (570) 286-3623

Other identifiers 3

IdentifierTypeStateIssuer
2146098OtherMDNCPDP
0349270171OtherMDPTAN
229737000MedicaidMD

Other names 1

  • WEIS PHARMACY #121 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081002000065 MD Part B Supplier - Mass Immunization (Roster Biller Only) 8527134642 33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Havre de Grace, MD; Hagerstown, MD; Ijamsville, MD; Laurel, MD; Lusby, MD; Mount Airy, MD; Nottingham, MD; Pasadena, MD…
O20250909001774 MD DME Supplier - PharmacyDME Supplier - Grocery Store 8527134642 Practice locations: Charlotte Hall, MD

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Weis Pharmacy Inc30015 Three Notch Rd, Charlotte Hall, MD 20622-4120(301) 905-0964 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Sep 1, 2008

National Provider Directory

National Provider Directory
Tax ID family
Weis Pharmacy 26128 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

30015 Three Notch Rd
Charlotte Hall, MD 20622
Phone (301) 905-0964

Practitioners & affiliated clinicians

Practitioners 1

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": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1154218279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 471",
            "city": "SUNBURY",
            "state": "PA",
            "postal_code": "178010471",
            "telephone_number": "570-286-3623",
            "fax_number": "570-988-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30015 THREE NOTCH RD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206224120",
            "telephone_number": "301-905-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIS MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "CICCO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VICE PRESIDENT, PHARMACY",
        "authorized_official_telephone_number": "570-286-3201",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2146098",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0349270171",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "229737000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEIS PHARMACY #121",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WEIS PHARMACY #121",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte Hall, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.