NPIMap

Organization Active NPI

Pleasant Ridge Manor

  • Long Term Care Pharmacy
  • Girard, PA
National Provider Identifier
1376659748
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
HP416565L Issued in PA
Legal business name
PLEASANT RIDGE MANOR
Practice address
8300 Ridge Rd
Girard, PA 16417-8701
Phone
(814) 474-5521
Fax
(814) 474-9431
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Robert Smith
Title
Exec Director
Phone
(814) 474-5521

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X HP416565L PA Primary

Addresses

Primary practice location

8300 Ridge Rd
Girard, PA 16417-8701

Mailing address

8300 Ridge Rd
Girard, PA 16417-8701
Phone (814) 474-5521

Other identifiers 2

IdentifierTypeStateIssuer
1007744350006MedicaidPA
2081200OtherPK

Other names 1

  • PLEASANT RIDGE MANOR PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pleasant Ridge Manor2 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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1376659748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 RIDGE RD",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164178701",
            "telephone_number": "814-474-5521",
            "fax_number": "814-474-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 RIDGE RD",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164178701",
            "telephone_number": "814-474-5521",
            "fax_number": "814-474-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT RIDGE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXEC DIRECTOR",
        "authorized_official_telephone_number": "814-474-5521"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "PA",
            "license": "HP416565L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007744350006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLEASANT RIDGE MANOR PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Girard, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.