Individual provider Active NPI

Jeffrey Klare Holdren, RPH

  • Pharmacist
  • East Berlin, PA
National Provider Identifier
1174517684
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP035346L Issued in PA
Practice address
335 W King St
East Berlin, PA 17316-9730
Phone
(717) 259-0421
Fax
(717) 259-7016
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP035346L PA Primary

Addresses

Primary practice location

335 W King St
East Berlin, PA 17316-9730

Mailing address

PO Box 1013
335 West King St
East Berlin, PA 17316-1013
Phone (717) 259-0421

Other identifiers 1

IdentifierTypeStateIssuer
0560089MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP035346LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
East Berlin RX LLC PastSince Dec 6, 2020 Accepting new patients
East Berlin RX LLC PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174517684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1013",
            "address_2": "335 WEST KING ST",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173161013",
            "telephone_number": "717-259-0421",
            "fax_number": "717-259-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 W KING ST",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173169730",
            "telephone_number": "717-259-0421",
            "fax_number": "717-259-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDREN",
        "first_name": "JEFFREY",
        "middle_name": "KLARE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP035346L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0560089",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Berlin, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.