Active NPI
Ppmi Inc
- Community/Retail Pharmacy
- Wilmington, DE
National Provider Identifier
1437495371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PPMI INC
- Practice address
- 3610 Miller Rd
Wilmington, DE 19802-2524 - Phone
- (302) 764-5348
- Fax
- (302) 764-5349
- NPI assigned
- Dec 21, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gregory Mazzotta
- Title
- Owner
- Phone
- (302) 584-1972
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
3610 Miller Rd
Wilmington, DE 19802-2524
Mailing address
PO Box 378
Rockland, DE 19732-0378
Phone (302) 764-5348
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171964 | Medicaid | DE |
Other names 1
- Miller Road Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140522001604 | DE | Part B Supplier - Mass Immunization (Roster Biller Only) | 7719100551 | Practice locations: Wilmington, DE |
| O20220907000927 | DE | Part B Supplier - Pharmacy | 7719361948 | Practice locations: Wilmington, DE |
National Provider Directory
National Provider DirectoryLocations
3610 Miller Rd
Wilmington, DE 19802
Phone (302) 764-5348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745971200000",
"number": "1437495371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 378",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320378",
"telephone_number": "302-764-5348",
"fax_number": "302-764-5349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3610 MILLER RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198022524",
"telephone_number": "302-764-5348",
"fax_number": "302-764-5349"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PPMI INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-12-21",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A",
"authorized_official_last_name": "MAZZOTTA",
"authorized_official_first_name": "GREGORY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "302-584-1972"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171964",
"state": "DE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Miller Road Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.