NPIMap

Organization Active NPI

Redner's Markets Inc.

Doing business as Redner's Pharmacy #38

  • Community/Retail Pharmacy
  • Palmyra, PA
National Provider Identifier
1487055984
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
REDNER'S MARKETS INC.
Doing business as
Redner's Pharmacy #38
Practice address
110 Northside Commons
Palmyra, PA 17078-8663
Phone
(717) 473-4054
Fax
(717) 473-4051
NPI assigned
Sep 16, 2014
Last updated
Jan 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
Mrs. Nicole Keller
Title
Contract/Compliance Coordinator
Phone
(484) 248-5873

Specialties & licenses 1

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

Addresses

Primary practice location

110 Northside Commons
Palmyra, PA 17078-8663

Mailing address

110 Northside Commons
Palmyra, PA 17078-8663
Phone (717) 473-4054

Other identifiers 1

IdentifierTypeStateIssuer
1007522960013MedicaidPA

Other names 1

  • Redner's Pharmacy #38 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110317000605 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3274653670 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shenandoah, PA; Palmyra, PA; Hegins, PA; Fredericksburg, PA; Leesport, PA
O20150721000609 PA DME Supplier - Pharmacy 3274653670 Practice locations: Palmyra, PA

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

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

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
Redners Pharmacy #38110 Northside CMNS, Palmyra, PA 17078-8663(717) 473-4054 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Osteogenesis Stimulators|Canes and/or Crutches|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies… Accepts assignmentParticipating since Jan 11, 2002

National Provider Directory

National Provider Directory
Tax ID family
Redners Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1487055984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 NORTHSIDE COMMONS",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170788663",
            "telephone_number": "717-473-4054",
            "fax_number": "717-473-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NORTHSIDE COMMONS",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170788663",
            "telephone_number": "717-473-4054",
            "fax_number": "717-473-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDNER'S MARKETS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CONTRACT/COMPLIANCE COORDINATOR",
        "authorized_official_telephone_number": "484-248-5873",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007522960013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redner's Pharmacy #38",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmyra, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.