Organization Active NPI

Primary Choice Pharmacy LLC

  • Pharmacy
  • Philadelphia, PA
National Provider Identifier
1194126128
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP482510 Issued in PA
Legal business name
PRIMARY CHOICE PHARMACY LLC
Practice address
5575 Old York Rd
Philadelphia, PA 19141
Phone
(215) 437-9043
Fax
(215) 437-9045
NPI assigned
Sep 9, 2014
Last updated
Jul 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Authorized official

Name
Dr. Emmanuil Shamilov
Title
Owner
Phone
(215) 437-9043

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PP482510 PA
Pharmacy 333600000X PP482510 PA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

5575 Old York Rd
Philadelphia, PA 19141

Mailing address

5575 Old York Rd
Philadelphia, PA 19141
Phone (215) 437-9043

Other identifiers 2

IdentifierTypeStateIssuer
1194126128OtherPADURABLE MEDICAL EQUIPMENT
1029774280002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160208000287 PA Part B Supplier - Pharmacy 9335466853 Practice locations: Philadelphia, PA

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
Primary Choice Pharmacy LLC5575 Old York Rd, Philadelphia, PA 19141-3001(215) 437-9043 Epoetin|Immunosuppressive Drugs|Infusion 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)|Heat & Cold Applications|(TENS) Transcutaneous Electrical Nerve Stimula… Does not accept assignmentParticipating since Jan 6, 2015

National Provider Directory

National Provider Directory

Locations

5575 Old York Rd
Philadelphia, PA 19141
Phone (215) 437-9043

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": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1194126128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-437-9043",
            "fax_number": "215-437-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-437-9043",
            "fax_number": "215-437-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CHOICE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "SHAMILOV",
        "authorized_official_first_name": "EMMANUIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-437-9043",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP482510",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP482510",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPMENT",
            "identifier": "1194126128",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029774280002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 8, 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.