Individual provider Active NPI

Alyssa Koffer

  • Pharmacist
  • Macungie, PA
National Provider Identifier
1306664289
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30278653 Issued in PA
Practice address
3440 Grandview Dr
Macungie, PA 18062-8502
Phone
(484) 232-6863
Fax
(484) 232-6342
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30278653 PA Primary

Addresses

Primary practice location

3440 Grandview Dr
Macungie, PA 18062-8502

Mailing address

3075 Main St
Green Lane, PA 18054-2237
Phone (484) 725-0506

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

State licenses

LicenseStateTypeSpecialty
30278653PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Weis Markets Inc CurrentSince Oct 6, 2024 Accepting new patients
Weis Markets Inc PastSince Oct 6, 2024 Accepting new patients

Locations

3440 Grandview Dr
Macungie, PA 18062
Phone (484) 232-6863

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.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1306664289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 MAIN ST",
            "city": "GREEN LANE",
            "state": "PA",
            "postal_code": "180542237",
            "telephone_number": "484-725-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 GRANDVIEW DR",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180628502",
            "telephone_number": "484-232-6863",
            "fax_number": "484-232-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFFER",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "30278653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macungie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.