Gerritys Supermarket Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481598 Issued in PA

Legal business name

GERRITYS SUPERMARKET INC

Practice address

2280 Sans Souci Pkwy
Hanover Mall
Hanover Township, PA 18706-5049

Phone

(570) 812-0016

Fax

(570) 812-0017

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Lisa Dente, PHARMD RPH

Title

Pharmacy MGR

Phone

(570) 812-0016

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GERRITYS PHARMACY HANOVER Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

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

• Gerrity'S Supermarket, Inc.

  • Community/Retail Pharmacy
  • Scranton, PA
  • NPI 1154607497

  O20210518002172

  Same enrollment

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

Tax ID family

Gerrity'S Supermarket Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Gerrity'S Supermarket, Inc.

  • Community/Retail Pharmacy
  • Scranton, PA
  • NPI 1154607497
  NPD tax ID

Locations

Practitioners 3

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

• Lisa Dukes, PHARM D

  • Pharmacist
  • Hanover TWP, PA
  • NPI 1689436503
  NPD
• Mary Gibbons

  • Pharmacist
  • Covington Township, PA
  • NPI 1023549300
  NPD
• Joyce Fasula

  • Pharmacist
  • Hanover Township, PA
  • NPI 1043760663
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1528079191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N SOUTH RD",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185041430",
            "telephone_number": "570-342-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 SANS SOUCI PKWY",
            "address_2": "HANOVER MALL",
            "city": "HANOVER TOWNSHIP",
            "state": "PA",
            "postal_code": "187065049",
            "telephone_number": "570-812-0016",
            "fax_number": "570-812-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERRITYS SUPERMARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "DENTE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PHARMACY MGR",
        "authorized_official_telephone_number": "570-812-0016",
        "authorized_official_credential": "PHARMD RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016870200001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2087853",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GERRITYS PHARMACY HANOVER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Ann Rose Evanko, PHARMD
• Joyce Fasula
• Lisa Z Flick, LCSW
• Mary Beth Frye, LCSW
• Catherine Frances Gallagher, OT
• Karen J. Giles, D.C.
• Goss Chiropractic Clinic and Rehabilitation Center
• Jerry Willis Goss, DC
• Hampton House Operations LLC
• Hampton House-Wilkes-Barre PA, LLC

• Community/Retail Pharmacy in Hanover Township, PA
• Providers in Hanover Township, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.