Landis Super Market Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481083 Issued in PA

Legal business name

LANDIS SUPER MARKET INC

Practice address

2685 County Line Rd
Telford, PA 18969-1075

Phone

(215) 723-2302

Fax

(215) 723-3144

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Robert Killoran, B.S.P

Title

Pic/Pharmacy Manager

Phone

(717) 919-8936

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LANDIS PHARMACY Doing business as

Tax ID family

Landis Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Landis Super Market Inc

  • Community/Retail Pharmacy
  • Harleysville, PA
  • NPI 1558469486
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• June D Burkholder, RPH

  • Pharmacist
  • Telford, PA
  • NPI 1093700700
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1295814978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 COUNTY LINE RD",
            "city": "TELFORD",
            "state": "PA",
            "postal_code": "189691075",
            "telephone_number": "877-540-4748",
            "fax_number": "801-716-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 COUNTY LINE RD",
            "city": "TELFORD",
            "state": "PA",
            "postal_code": "189691075",
            "telephone_number": "215-723-2302",
            "fax_number": "215-723-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDIS SUPER MARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "KILLORAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PIC/PHARMACY MANAGER",
        "authorized_official_telephone_number": "717-919-8936",
        "authorized_official_credential": "B.S.P"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085685",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018678030002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LANDIS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Justofin, CRNP
• Joan Kenerson King, RN, MSN, CS
• Jean M Kramer, PTA
• Holly Kratz, LPC
• Suzanne Landis Kaczor
• Keryn Lederach
• Lisa Leszcynski
• Lutheran Community at Telford
• Grace Masakadza
• Natalie E McGann, D.O.

• Community/Retail Pharmacy in Telford, PA
• Providers in Telford, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.