Pottstown Discount Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482602 Issued in PA

Legal business name

POTTSTOWN DISCOUNT PHARMACY LLC

Doing business as

Pottstown Pharmacy

Practice address

1501 E High St
Pottstown, PA 19464-5005

Phone

(484) 644-3120

Fax

(484) 524-8277

NPI assigned

Dec 8, 2015

Organization subpart

No

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

Authorized official

Name

Imad Attalla

Title

Manager

Phone

(484) 644-3120

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• POTTSTOWN PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Tax ID family

Pottstown Discount Pharmacy LLC2 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.

• Pottstown Discount Pharmacy LLC

  dba Pottstown Pharmacy LTC

  • Long Term Care Pharmacy
  • Pottstown, PA
  • NPI 1376473009
  NPD tax ID

Locations

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1154796787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E HIGH ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194645005",
            "telephone_number": "484-644-3120",
            "fax_number": "484-524-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E HIGH ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194645005",
            "telephone_number": "484-644-3120",
            "fax_number": "484-524-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSTOWN DISCOUNT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-08",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "ATTALLA",
        "authorized_official_first_name": "IMAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "484-644-3120"
    },
    "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": "PP482602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030727030001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155827",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POTTSTOWN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.