CK-KC LTC, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PP415557L Issued in PA

Legal business name

CK-KC LTC, INC

Doing business as

Hershey Long Term Care Pharmacy

Practice address

1200 Grubb Street
Palmyra, PA 17078

Phone

(717) 832-2050

Fax

(717) 832-2051

NPI assigned

Sep 21, 2006

Last updated

Dec 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Kray, RPH

Title

President

Phone

(717) 832-2050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HERSHEY LONG TERM CARE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1548369028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRUBB RD",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170783514",
            "telephone_number": "717-832-2050",
            "fax_number": "717-832-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRUBB STREET",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "17078",
            "telephone_number": "717-832-2050",
            "fax_number": "717-832-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CK-KC LTC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "KRAY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-832-2050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "PA",
            "license": "PP415557L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MA1865498",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERSHEY LONG TERM CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HERSHEY LONG TERM CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Camdin Rebekia Carpenter, PA-C
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• Timothy Ryan Corl, O.D.
• Crosstown Dental Group

• Long Term Care Pharmacy in Palmyra, PA
• Providers in Palmyra, PA by specialty
• Long Term Care Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.