Active NPI
Ethan King
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1194641761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP460184
- Practice address
- 3400 Civic Center Blvd
Philadelphia, PA 19104-5127 - Phone
- (215) 615-7256
- NPI assigned
- Jun 26, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP460184 | PA | Primary |
Addresses
Primary practice location
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Mailing address
1813 N Howard St Apt 602
Philadelphia, PA 19122-2445
Phone (413) 335-7020
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1194641761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1813 N HOWARD ST APT 602",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191222445",
"telephone_number": "413-335-7020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "215-615-7256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "ETHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-26",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP460184",
"primary": true
}
],
"identifiers": [],
"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 Jun 26, 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.