NPIMap

Organization Active NPI

Reverence Discount Pharmacy

  • Community/Retail Pharmacy
  • Pleasantville, NJ
National Provider Identifier
1235679846
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
REVERENCE DISCOUNT PHARMACY
Practice address
912 S Main St
Pleasantville, NJ 08232-3618
Phone
(609) 445-4423
Fax
(609) 445-4423
NPI assigned
Mar 1, 2017
Last updated
Apr 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Widlyne RuffinNPI 1932651536
Title
Pharmacist
Phone
(609) 445-4423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Mail Order Pharmacy 3336M0002X
Managed Care Organization Pharmacy 3336M0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

912 S Main St
Pleasantville, NJ 08232-3618

Mailing address

5 Moonlight Dr
Egg Harbor TWP, NJ 08234-4927
Phone (609) 904-2540

Other identifiers 1

IdentifierTypeStateIssuer
2168126OtherPK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1235679846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MOONLIGHT DR",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082344927",
            "telephone_number": "609-904-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S MAIN ST",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082323618",
            "telephone_number": "609-445-4423",
            "fax_number": "609-445-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVERENCE DISCOUNT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "RUFFIN",
        "authorized_official_first_name": "WIDLYNE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "609-445-4423"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168126",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasantville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.