Eric Matthew Pavelik, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP040806L Issued in PA

Practice address

99 Masonic Dr Ste 103
Elizabethtown, PA 17022-2573

Phone

(717) 361-5599

Fax

(717) 361-3908

NPI assigned

May 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1346823572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WILLOW RDG",
            "city": "NEW HOLLAND",
            "state": "PA",
            "postal_code": "175571446",
            "telephone_number": "610-639-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MASONIC DR STE 103",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222573",
            "telephone_number": "717-361-5599",
            "fax_number": "717-361-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELIK",
        "first_name": "ERIC",
        "middle_name": "MATTHEW",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP040806L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MASONICVILLAGES.ORG",
            "affiliation": "N",
            "endpointDescription": "SECURE NETWORK",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "99 Masonic Dr Ste 103",
            "city": "Elizabethtown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170222573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Elizabethtown, PA
• Providers in Elizabethtown, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.