The Vaccine Shoppe, LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

THE VACCINE SHOPPE, LLC

Practice address

205 Butler Street
Pittston, PA 18640

Phone

(570) 762-9132

NPI assigned

Feb 24, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Sami Lynn Kristin Panek, RPH

Title

Manager

Phone

(570) 762-9132

Specialties & licenses 4

Addresses

Tax ID family

The Vaccine Shoppe LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Vaccine Shoppe, LLC

  • Non-Pharmacy Dispensing Site
  • Pittston, PA
  • NPI 1194470682
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samilynn Kristin Polit-Panek

  • Pharmacist
  • Exeter, PA
  • NPI 1316751571
  NPD

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1336895796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 YORK AVE",
            "city": "WEST PITTSTON",
            "state": "PA",
            "postal_code": "186432435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BUTLER STREET",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "18640",
            "telephone_number": "570-762-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VACCINE SHOPPE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "PANEK",
        "authorized_official_first_name": "SAMI LYNN",
        "authorized_official_middle_name": "KRISTIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "570-762-9132",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley Talarico
• Terrana Counseling
• Antoinette Terrana, MA, PC
• The Gregory Center for Applied Behavior Analysis
• The Vaccine Shoppe, LLC
• Timothy Mark Opiel Dentistry LLC
• Lisa F Tomcykoski, PHARMD
• Thomas Howard Tonkin, D.O.
• Michalene Torbik, D.O.
• Eileen T Toussaint, RPH

• Community Health Clinic/Center in Pittston, PA
• Providers in Pittston, PA by specialty
• Community Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.