Active NPI
Beverly A Kennedy, RPH
- Pharmacist
- Conneaut Lake, PA
National Provider Identifier
1285800862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP042593L
- Practice address
- 100 S Third St
Conneaut Lake, PA 16316 - Phone
- (814) 382-2380
- Fax
- (814) 382-2818
- NPI assigned
- May 5, 2008
- Sex
- Female
- 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 | RP042593L | PA | Primary |
Addresses
Primary practice location
100 S Third St
Conneaut Lake, PA 16316
Mailing address
100 South 3Rd St
Conneaut Lake, PA 16316
Phone (814) 382-2380
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP042593L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrift Drug Inc | Past | Accepting new patients | |
| Thrift Drug Inc | Past | 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.
-
- Community/Retail Pharmacy
- Conneaut Lake, PA
- NPI 1063596708
-
- Community/Retail Pharmacy
- Hamburg, NJ
- NPI 1114026341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1285800862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SOUTH 3RD ST",
"city": "CONNEAUT LAKE",
"state": "PA",
"postal_code": "16316",
"telephone_number": "814-382-2380",
"fax_number": "814-382-2818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S THIRD ST",
"city": "CONNEAUT LAKE",
"state": "PA",
"postal_code": "16316",
"telephone_number": "814-382-2380",
"fax_number": "814-382-2818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "BEVERLY",
"middle_name": "A",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP042593L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conneaut Lake, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.