Individual provider Active NPI

Justin Gronauer, PHARMD

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1477449080
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP457061 Issued in PA
Practice address
2640 E Cumberland St
Philadelphia, PA 19125-3709
Phone
(215) 291-8315
NPI assigned
Jun 18, 2025
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP457061 PA Primary

Addresses

Primary practice location

2640 E Cumberland St
Philadelphia, PA 19125-3709

Mailing address

2640 E Cumberland St
Philadelphia, PA 19125-3709
Phone (215) 291-8315

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

State licenses

LicenseStateTypeSpecialty
RP457061PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania CVS Pharmacy, L.L.C. CurrentSince Jun 23, 2025 Accepting new patients
Pennsylvania CVS Pharmacy, L.L.C. PastSince Jun 23, 2025 Accepting new patients

Locations

2640 E Cumberland St
Philadelphia, PA 19125
Phone (215) 291-8315

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1477449080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 E CUMBERLAND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253709",
            "telephone_number": "215-291-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 E CUMBERLAND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253709",
            "telephone_number": "215-291-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONAUER",
        "first_name": "JUSTIN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP457061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 18, 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.

Verify at the official NPI Registry.