NPIMap

Organization Active NPI

Philadelphia Department of Public Health Center Pharmacy Strawberry

Doing business as Pharmacy Strawberry Mansion Health Center

  • Clinic Pharmacy
  • Philadelphia, PA
National Provider Identifier
1487730222
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY STRAWBERRY
Doing business as
Pharmacy Strawberry Mansion Health Center
Practice address
2840 W Dauphin Street
Philadelphia, PA 19132
Phone
(215) 685-2419
NPI assigned
Oct 27, 2006
Last updated
Mar 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Authorized official

Name
Mr. Jeffrey T. Pender, RPH
Title
Director of Pharmaceutical Services
Phone
(215) 685-6864

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X PP413927L PA
Federally Qualified Health Center (FQHC) 261QF0400X PA
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

2840 W Dauphin Street
Philadelphia, PA 19132

Mailing address

500 S. Broad Street
Pharmacy/Basement
Philadelphia, PA 19146
Phone (215) 685-6864

Other identifiers 1

IdentifierTypeStateIssuer
1000076950082MedicaidPA

Other names 1

  • Pharmacy Strawberry Mansion Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phila HLTH Ctr No 523 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1487730222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S. BROAD STREET",
            "address_2": "PHARMACY/BASEMENT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19146",
            "telephone_number": "215-685-6864",
            "fax_number": "215-790-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 W DAUPHIN STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19132",
            "telephone_number": "215-685-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY STRAWBERRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "PENDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACEUTICAL SERVICES",
        "authorized_official_telephone_number": "215-685-6864",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PA",
            "license": "PP413927L",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000076950082",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy Strawberry Mansion Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pharmacy Strawberry Mansion Health Center",
            "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 Mar 7, 2019; 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.