Organization Active NPI

GDD Pharmacy Services Inc

Doing business as Pine Grove Pharmacy

  • Community/Retail Pharmacy
  • Pine Grove, PA
National Provider Identifier
1295876217
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GDD PHARMACY SERVICES INC
Doing business as
Pine Grove Pharmacy
Practice address
10 E Pottsville St
Pine Grove, PA 17963-1100
Phone
(570) 345-4422
Fax
(570) 345-8708
NPI assigned
Feb 11, 2007
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

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

Specialties & licenses 3

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

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 names 1

  • Pine Grove Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

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

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

NPI Registry JSON

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

{
    "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": [],
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.