GDD Pharmacy Services Inc – Community/Retail Pharmacy

Key facts

NPI: 1295876217
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
Legal business name: GDD PHARMACY SERVICES INC
Practice address: 10 E Pottsville St
Pine Grove, PA 17963-1100
Phone: (570) 345-4422
Fax: (570) 345-8708
NPI assigned: Feb 11, 2007
Organization subpart: No

Authorized official

Name: Darrin Silbaugh
Title: Pres
Phone: (717) 732-2112

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

GDD Pharmacy Services Inc Community/Retail Pharmacy · Harrisburg, PA · NPI 1548271117

Same enrollment O20180322000976
GDD Pharmacy Services Inc Community/Retail Pharmacy · Harrisburg, PA · NPI 1669555223

Same enrollment O20180322000976

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20180322000976	PA	Part B Supplier - Mass Immunization (Roster Biller Only)	5496876542	2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Harrisburg, PA; Pine Grove, PA

National Provider Directory

Locations

8 E Pottsville St
#10
Pine Grove, PA 17963
Phone (570) 345-4422

8 E Pottsville St
Pine Grove, PA 17963

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X	PP411879L	PA
Community/Retail Pharmacy	3336C0003X			Yes

Addresses

Primary practice location

10 E Pottsville St
Pine Grove, PA 17963-1100

Mailing address

10 E Pottsville St
Pine Grove, PA 17963-1100
Phone (570) 345-4422

Other identifiers

Identifier	Type	State	Issuer
2160331	Other		PK
0017986620004	Medicaid	PA

Other names

Pine Grove Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 12, 2024.

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1295876217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E POTTSVILLE ST",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631100",
            "telephone_number": "570-345-4422",
            "fax_number": "570-345-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E POTTSVILLE ST",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631100",
            "telephone_number": "570-345-4422",
            "fax_number": "570-345-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GDD PHARMACY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-11",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "SILBAUGH",
        "authorized_official_first_name": "DARRIN",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "717-732-2112"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP411879L",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160331",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017986620004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Grove Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pine Grove Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pine Grove, PA

All providers in Pine Grove, PA · Community/Retail Pharmacy in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.