NPIMap

Organization Active NPI

Upmc Somerset

Doing business as Somerset Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Somerset, PA
National Provider Identifier
1306397948
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482713 Issued in PA
Legal business name
UPMC SOMERSET
Doing business as
Somerset Hospital Outpatient Pharmacy
Practice address
225 S Center Ave Ste 1049
Somerset, PA 15501-2033
Phone
(814) 443-5352
Fax
(814) 443-5235
NPI assigned
Oct 19, 2016
Last updated
Apr 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Authorized official

Name
Andrew RushNPI 1134332927
Title
Chief Executive Officer
Phone
(814) 443-5000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP482713 PA Primary

Addresses

Primary practice location

225 S Center Ave Ste 1049
Somerset, PA 15501-2033

Mailing address

225 S Center Ave Ste 1049
Somerset, PA 15501-2033
Phone (814) 443-5352

Other identifiers 2

IdentifierTypeStateIssuer
1002086660044MedicaidPA
2164591OtherPK

Other names 1

  • Somerset Hospital Outpatient Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170511002738 PA Part B Supplier - Pharmacy 1355235144 Practice locations: Somerset, PA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

225 S Center Ave
Ste 1049
Somerset, PA 15501
Phone (814) 443-5352

Practitioners & affiliated clinicians

Practitioners 2

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": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1306397948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S CENTER AVE STE 1049",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155012033",
            "telephone_number": "814-443-5352",
            "fax_number": "814-443-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S CENTER AVE STE 1049",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155012033",
            "telephone_number": "814-443-5352",
            "fax_number": "814-443-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC SOMERSET",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "814-443-5000"
    },
    "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": "PP482713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002086660044",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164591",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerset Hospital Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerset, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.