Active NPI
Nana Mubbala
- Pharmacist
- Harrisburg, PA
National Provider Identifier
1497596969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP039550L
- Practice address
- 2723 Agate St
Harrisburg, PA 17110-2645 - Phone
- (717) 213-0968
- Fax
- (717) 213-0956
- NPI assigned
- Jun 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP039550L | PA | Primary |
Addresses
Primary practice location
2723 Agate St
Harrisburg, PA 17110-2645
Mailing address
2723 Agate St
Harrisburg, PA 17110-2645
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP039550L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Shore Pharmacy Inc. | Current | Accepting new patients |
Locations
2723 Agate St
Harrisburg, PA 17110
Phone (717) 213-0968
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Harrisburg, PA
- NPI 1093722134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1497596969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2723 AGATE ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171102645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2723 AGATE ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171102645",
"telephone_number": "717-213-0968",
"fax_number": "717-213-0956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUBBALA",
"first_name": "NANA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-06",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP039550L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.