NPIMap

Organization Active NPI

Nazareth Hospital

Doing business as Nazareth Outpatient Pharmacy

  • Pharmacy
  • Philadelphia, PA
National Provider Identifier
1407590151
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NAZARETH HOSPITAL
Doing business as
Nazareth Outpatient Pharmacy
Practice address
2601 Holme Ave Ste 100
Philadelphia, PA 19152-2007
Phone
(215) 335-6043
Fax
(215) 335-6598
NPI assigned
Apr 27, 2022
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NAZARETH HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
David Wajda
Title
Director, Finance
Phone
(215) 335-6043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

2601 Holme Ave Ste 100
Philadelphia, PA 19152-2007

Mailing address

2601 Holme Ave Ste 100
Philadelphia, PA 19152-2007
Phone (215) 335-6043

Other names 1

  • Nazareth Outpatient Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230307002446 PA DME Supplier - Pharmacy 1951202910 Practice locations: Philadelphia, PA
O20230321000116 PA Part B Supplier - Pharmacy 1951202910 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Nazareth Hospital2601 Holme Ave, Philadelphia, PA 19152-2007(215) 335-7985 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Mar 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
NH House Physiciansnaz8 organizations share this tax ID, including this one
Part of
NH House Physiciansnaz

Other organizations with this tax ID 7

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

Locations

2601 Holme Ave
Ste 100
Philadelphia, PA 19152
Phone (215) 335-6043

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1407590151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE STE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6043",
            "fax_number": "215-335-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE STE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6043",
            "fax_number": "215-335-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZARETH HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAZARETH HOSPITAL",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "WAJDA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "215-335-6043"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nazareth Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.