Eddystone Community Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482215 Issued in PA

Legal business name

EDDYSTONE COMMUNITY PHARMACY

Practice address

1207B Chester Pike
Eddystone, PA 19022-1332

Phone

(484) 480-3341

Fax

(484) 480-3344

NPI assigned

Feb 3, 2012

Last updated

Aug 6, 2012By 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. Igdaliah Jackson, PHARMDNPI 1700210184

Title

Pharmacist/Owner

Phone

(484) 480-3341

Specialties & licenses 9

Addresses

Practitioners 2

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.

• Igdaliah Jackson, PHARM D

  • Pharmacist
  • Eddystone, PA
  • NPI 1700210184
  NPD Authorized official
• Douglas Smith, PHARMD

  • Pharmacist
  • Eddystone, PA
  • NPI 1104653864
  NPD

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1578835740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207B CHESTER PIKE",
            "city": "EDDYSTONE",
            "state": "PA",
            "postal_code": "190221332",
            "telephone_number": "484-480-3341",
            "fax_number": "484-480-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207B CHESTER PIKE",
            "city": "EDDYSTONE",
            "state": "PA",
            "postal_code": "190221332",
            "telephone_number": "484-480-3341",
            "fax_number": "484-480-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDYSTONE COMMUNITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "IGDALIAH",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "484-480-3341",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP482215",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482215",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collins Markets LLC (Shoprite Pharmacy of Eddystone)
• Community Transit of Delaware County
• County of Delaware
• Keshla Marie Cruz
• Chabreena Jamiel Dixon, MS
• Eddystone Fire Company No 1
• Chimene N Fachehoun
• Dorothy Fessler, RN
• Latifah Griffin
• Grossinger Neuropain Specialists PC

• Community/Retail Pharmacy in Eddystone, PA
• Providers in Eddystone, 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 Aug 6, 2012; 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.