NPIMap

Organization Active NPI

Geisinger Pharmacy, LLC

Doing business as Geisinger Mail Order Pharmacy

  • Mail Order Pharmacy
  • Elysburg, PA
National Provider Identifier
1548709561
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
PP482708 Issued in PA
Legal business name
GEISINGER PHARMACY, LLC
Doing business as
Geisinger Mail Order Pharmacy
Practice address
210 Industrial Park Rd
Elysburg, PA 17824-9770
Phone
(844) 878-5562
Fax
(570) 221-3711
NPI assigned
Feb 23, 2017
Last updated
Nov 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Michael A Evans
Title
Director-Retail and Mail Order
Phone
(570) 271-6912

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Mail Order Pharmacy 3336M0002X PP482708 PA Primary

Addresses

Primary practice location

210 Industrial Park Rd
Elysburg, PA 17824-9770

Mailing address

100 N Academy Ave
Danville, PA 17822-2575
Phone (570) 271-7965

Other identifiers 2

IdentifierTypeStateIssuer
1007535151365MedicaidPA
2167984OtherPK

Other names 1

  • Geisinger Mail Order Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201104000866 PA DME Supplier - Pharmacy 0244640126 Practice locations: Elysburg, PA

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Geisinger Pharmacy LLC210 Industrial Park Rd, Elysburg, PA 17824-9770(844) 878-4452 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 7, 2021

National Provider Directory

National Provider Directory
Tax ID family
Geisingr Pharmacy LLC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

100 N Academy Ave
#2575
Danville, PA 17822

NPI Registry JSON

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1548709561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222575",
            "telephone_number": "570-271-7965",
            "fax_number": "570-271-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 INDUSTRIAL PARK RD",
            "city": "ELYSBURG",
            "state": "PA",
            "postal_code": "178249770",
            "telephone_number": "844-878-5562",
            "fax_number": "570-221-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISINGER PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-23",
        "last_updated": "2020-11-16",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR-RETAIL AND MAIL ORDER",
        "authorized_official_telephone_number": "570-271-6912"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "PA",
            "license": "PP482708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007535151365",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167984",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geisinger Mail Order Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Geisinger Mail Order Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elysburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.