NPIMap

Organization Active NPI

Medarbor LLC

  • Community/Retail Pharmacy
  • Bristol, PA
National Provider Identifier
1407088156
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP481966 Issued in PA
Legal business name
MEDARBOR LLC
Practice address
200 Rittenhouse Cir BLDG Suitee3
Bristol, PA 19007-1619
Phone
(610) 660-8100
Fax
(866) 740-4689
NPI assigned
Aug 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Miroslav Kesic, PHARM.D.
Title
President
Phone
(610) 660-8100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP481966 PA Primary

Addresses

Primary practice location

200 Rittenhouse Cir BLDG Suitee3
Bristol, PA 19007-1619

Mailing address

200 Rittenhouse Cir Ste 3E
Bristol, PA 19007-1625
Phone (610) 660-8100

Other identifiers 2

IdentifierTypeStateIssuer
102401469MedicaidPA
2121939OtherPK

National Provider Directory

National Provider Directory
Tax ID family
Medarbor LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

200 Rittenhouse Cir
Bldg SUITEE3
Bristol, PA 19007
Phone (610) 660-8100

200 Rittenhouse Cir
Ste 3E
Bristol, PA 19007

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1407088156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RITTENHOUSE CIR STE 3E",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190071625",
            "telephone_number": "610-660-8100",
            "fax_number": "866-740-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RITTENHOUSE CIR BLDG SUITEE3",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190071619",
            "telephone_number": "610-660-8100",
            "fax_number": "866-740-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDARBOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "KESIC",
        "authorized_official_first_name": "MIROSLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-660-8100",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102401469",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121939",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.