NPIMap

Organization Active NPI

Landis Super Market Inc

Doing business as Landis Pharmacy Vernfield

  • Community/Retail Pharmacy
  • Harleysville, PA
National Provider Identifier
1558469486
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP481624 Issued in PA
Legal business name
LANDIS SUPER MARKET INC
Doing business as
Landis Pharmacy Vernfield
Practice address
2700 Shelly Rd
Harleysville, PA 19438-1281
Phone
(215) 513-3053
Fax
(215) 513-3052
NPI assigned
Sep 21, 2006
Last updated
Jul 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
David Gutekunst, RPHNPI 1336137017
Title
Pic
Phone
(215) 513-3053

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP481624 PA Primary

Addresses

Primary practice location

2700 Shelly Rd
Harleysville, PA 19438-1281

Mailing address

2700 Shelly Rd
Harleysville, PA 19438-1281
Phone (877) 540-4748

Other identifiers 2

IdentifierTypeStateIssuer
2088154OtherPK
0018678030002MedicaidPA

Other names 1

  • LANDIS PHARMACY VERNFIELD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Landis Pharmacy2 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.

Locations

2700 Shelly Rd
Harleysville, PA 19438
Phone (215) 513-3053

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1558469486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SHELLY RD",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194381281",
            "telephone_number": "877-540-4748",
            "fax_number": "801-716-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SHELLY RD",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194381281",
            "telephone_number": "215-513-3053",
            "fax_number": "215-513-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDIS SUPER MARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "GUTEKUNST",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "215-513-3053",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2088154",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018678030002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LANDIS PHARMACY VERNFIELD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harleysville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.