Pennscarerx Pharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00720400 Issued in NJ

Legal business name

PENNSCARERX PHARMA INC

Practice address

182 N Broadway
Pennsville, NJ 08070-1419

Phone

(856) 514-2638

Fax

(856) 514-2678

NPI assigned

Jun 29, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Yadagiri Pendyala

Title

Pharmacist-in-Charge

Phone

(917) 972-3340

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PENNSCARE FAMILY PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472256000000",
    "number": "1336403773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701419",
            "telephone_number": "856-514-2638",
            "fax_number": "856-514-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701419",
            "telephone_number": "856-514-2638",
            "fax_number": "856-514-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSCARERX PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2016-08-27",
        "status": "A",
        "authorized_official_last_name": "PENDYALA",
        "authorized_official_first_name": "YADAGIRI",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "917-972-3340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00720400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136131",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0383929",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENNSCARE FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pennsville Al, LLC
• Pennsville Medical Imaging
• Pennsville Radiology Inc.
• Pennsville School District
• David J Peregmon, OTR

• Community/Retail Pharmacy in Pennsville, NJ
• Providers in Pennsville, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; 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.