Shady Maple Pharmacy at Garden Spot Village

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482276 Issued in PA

Legal business name

SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE

Doing business as

SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE

Practice address

433 S Kinzer Ave
New Holland, PA 17557-8736

Phone

(717) 355-6155

Fax

(717) 355-6156

NPI assigned

Apr 22, 2013

Organization subpart

No

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

Authorized official

Name

Elwood Martin

Title

President

Phone

(717) 354-4891

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE Doing business as

Tax ID family

Shady Maple Pharmacy2 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.

• Shady Maple Pharmacy

  • Community/Retail Pharmacy
  • East Earl, PA
  • NPI 1932145950
  NPD tax ID

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1376987313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 S KINZER AVE",
            "city": "NEW HOLLAND",
            "state": "PA",
            "postal_code": "175578736",
            "telephone_number": "717-355-6155",
            "fax_number": "717-355-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 S KINZER AVE",
            "city": "NEW HOLLAND",
            "state": "PA",
            "postal_code": "175578736",
            "telephone_number": "717-355-6155",
            "fax_number": "717-355-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ELWOOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-354-4891"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139988",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marc L Schaffer, MS, LAT, ATC
• Christian Scorza, DPT
• Rachel Lira Sensenig, FNP-BC
• Ruth Elizabeth Sensenig
• Serenity Therapeutic Massage
• John J Sheaffer, DMD
• Andrew Sieger, DMD
• Katelyn Ann Smith, RD, LDN
• Jennifer R Smucker, LPN
• Shweta Soni, MD

• Community/Retail Pharmacy in New Holland, PA
• Providers in New Holland, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.