South Mountain Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PP410161L Issued in PA

Legal business name

SOUTH MOUNTAIN PHARMACY

Practice address

2441 W Emmaus Ave
Allentown, PA 18103-7234

Phone

(610) 791-3917

Fax

(610) 791-3962

NPI assigned

Nov 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lane M Freeman, R.PH

Title

Owner

Phone

(610) 791-3917

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326112772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 W EMMAUS AVE",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181037234",
            "telephone_number": "610-791-3917",
            "fax_number": "610-791-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 W EMMAUS AVE",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181037234",
            "telephone_number": "610-791-3917",
            "fax_number": "610-791-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MOUNTAIN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-791-3917",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP410161L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015684200002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E Andrew Leyco Sotomango, PA-C
• Rachel Marie Sottolano, RDN
• Dylan Michael Souder, DO
• Craig M. Souders, M.P.T.
• Sydney Elaina Souliere, PA-C
• Shaune Corrinne Southern, CRNA
• Southerncare, Inc. (Heartland)
• Robert James Spade II, DPT
• Heather Spadola, PT, DPT
• Dana L Spadt, PA

• Pharmacy in Allentown, PA
• Providers in Allentown, PA by specialty
• Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.