NPIMap

Organization Active NPI

Hillrise Pharmacy LLC

  • Community/Retail Pharmacy
  • Philadelphia, PA
National Provider Identifier
1154778983
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482646 Issued in PA
Legal business name
HILLRISE PHARMACY LLC
Practice address
4240 N Broad St Unit B
Philadelphia, PA 19140-1908
Phone
(215) 403-7300
Fax
(267) 335-3937
NPI assigned
May 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Authorized official

Name
Omotayo Badejoko, B PHARMNPI 1568746428
Title
Member/Owner
Phone
(484) 326-1877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP482646 PA Primary

Addresses

Primary practice location

4240 N Broad St Unit B
Philadelphia, PA 19140-1908

Mailing address

4240 N Broad St Unit B
Philadelphia, PA 19140-1908
Phone (215) 403-7300

Other identifiers 2

IdentifierTypeStateIssuer
2160216OtherPK
1031140170001MedicaidPA

Other names 1

  • HillRise Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hillrise Pharmacy2 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

4240 N Broad St
Unit B
Philadelphia, PA 19140
Phone (215) 403-7300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1154778983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 N BROAD ST UNIT B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401908",
            "telephone_number": "215-403-7300",
            "fax_number": "267-335-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 N BROAD ST UNIT B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401908",
            "telephone_number": "215-403-7300",
            "fax_number": "267-335-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLRISE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-23",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "BADEJOKO",
        "authorized_official_first_name": "OMOTAYO",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "484-326-1877",
        "authorized_official_credential": "B PHARM"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160216",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031140170001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HillRise Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.