Active NPI
Jared Scott Waxman, PHARMD, RPH
- Pharmacist
- Havertown, PA
National Provider Identifier
1407447204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP453684
- Practice address
- 2 E Eagle Rd
Havertown, PA 19083-1495 - Phone
- (610) 446-4040
- Fax
- (610) 446-7902
- NPI assigned
- Feb 3, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP453684 | PA | Primary |
Addresses
Primary practice location
2 E Eagle Rd
Havertown, PA 19083-1495
Mailing address
325 Penn Rd Unit 145
Wynnewood, PA 19096-1448
Other practice location 1
2070 Sproul Rd
Broomall, PA 19008-2725
Phone (610) 356-6491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP453684 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C & M Pharmacy Inc | Past | Accepting new patients | |
| Roosevelt Pharmacy LLC | Past | Accepting new patients | |
| BH Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Philadelphia, PA
- NPI 1033820113
-
- Community/Retail Pharmacy
- Havertown, PA
- NPI 1821018383
-
- Community/Retail Pharmacy
- Philadelphia, PA
- NPI 1184241408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760400000000",
"number": "1407447204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 PENN RD UNIT 145",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190961448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 E EAGLE RD",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190831495",
"telephone_number": "610-446-4040",
"fax_number": "610-446-7902"
}
],
"practiceLocations": [
{
"address_1": "2070 Sproul Rd",
"address_purpose": "LOCATION",
"city": "Broomall",
"state": "PA",
"postal_code": "190082725",
"country_code": "US",
"telephone_number": "610-356-6491",
"fax_number": "610-356-6492",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAXMAN",
"first_name": "JARED",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-03",
"last_updated": "2025-10-14",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP453684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Havertown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.