NPIMap

Organization Active NPI

Wellspan Pharmacy Inc

  • Community/Retail Pharmacy
  • Lebanon, PA
National Provider Identifier
1477095172
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WELLSPAN PHARMACY INC
Practice address
252 S 4TH St
Lebanon, PA 17042-6111
Phone
(717) 741-8151
NPI assigned
Nov 11, 2016
Last updated
Aug 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
Mr. Kevin Charnetski, PHARM DNPI 1952712408
Title
Director
Phone
(570) 262-6663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

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

Addresses

Primary practice location

252 S 4TH St
Lebanon, PA 17042-6111

Mailing address

PO Box 20129
York, PA 17402-0140
Phone (717) 851-6903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090924000486 PA Part B Supplier - Mass Immunization (Roster Biller Only) 2264588730 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfield, PA; Gettysburg, PA; Lebanon, PA; York, PA; Ephrata, PA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

912 S George St
York, PA 17403
Phone (717) 741-8151

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": "1478822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1477095172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20129",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174020140",
            "telephone_number": "717-851-6903",
            "fax_number": "717-851-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 S 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426111",
            "telephone_number": "717-741-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-11",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "CHARNETSKI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "570-262-6663",
        "authorized_official_name_prefix": "Mr.",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.

Verify at the official NPI Registry.