Organization Active NPI

Nice Pharmacy

  • Pharmacy
  • Philadelphia, PA
National Provider Identifier
1528048873
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP415588L Issued in PA
Legal business name
NICE PHARMACY
Practice address
110 E Allegheny Ave
Philadelphia, PA 19134-2207
Phone
(215) 425-0100
Fax
(215) 425-2524
NPI assigned
Jan 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Randal Mathew Policare, RPHNPI 1316563570
Title
Vice President
Phone
(215) 425-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP415588L PA Primary

Addresses

Primary practice location

110 E Allegheny Ave
Philadelphia, PA 19134-2207

Mailing address

110 E Allegheny Ave
Philadelphia, PA 19134-2207
Phone (215) 425-0100

Other identifiers 3

IdentifierTypeStateIssuer
39-76581OtherPANCPDP NUMBER
0017694730001MedicaidPA
PP-415588LOtherPASTATE PHARMACY #

National Provider Directory

National Provider Directory

Locations

110 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 425-0100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1528048873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342207",
            "telephone_number": "215-425-0100",
            "fax_number": "215-425-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342207",
            "telephone_number": "215-425-0100",
            "fax_number": "215-425-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "POLICARE",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-425-0100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP415588L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "39-76581",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017694730001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY #",
            "identifier": "PP-415588L",
            "state": "PA"
        }
    ],
    "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 Mar 7, 2023; 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.