Crestwood Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410503L Issued in PA

Legal business name

CRESTWOOD PHARMACY LLC

Practice address

10 S Mountain Blvd
Mountain Top, PA 18707-1123

Phone

(570) 474-5859

Fax

(570) 474-9594

NPI assigned

Jan 8, 2015

Organization subpart

No

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

Authorized official

Name

Jessica Orloski

Title

Member

Phone

(570) 474-5859

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Crestwood Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

Crestwood 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.

• Crestwood Pharmacy LLC

  • Long Term Care Pharmacy
  • Mountain Top, PA
  • NPI 1245006527
  NPD tax ID

Locations

Practitioners 2

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

• Jessica Lynn Ashford, PHARMD

  • Pharmacist
  • Dallas, PA
  • NPI 1992009195
  NPD
• Sonya Lea Mylet, PHARM D

  • Pharmacist
  • Mountain Top, PA
  • NPI 1356946107
  NPD

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1588052872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071123",
            "telephone_number": "570-474-5859",
            "fax_number": "570-474-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071123",
            "telephone_number": "570-474-5859",
            "fax_number": "570-474-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "ORLOSKI",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "570-474-5859"
    },
    "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": "PP410503L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029974200001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexanne Kennedy Conklin, MS.CCC/SLP
• Connors Chiropractic LLC
• Patrick J Connors, DC
• Crestwood Pharmacy
• Crestwood Pharmacy LLC
• Crestwood School District
• Data Makes the Difference, LLC
• Davis Nursing Home, Inc.
• Kristina Marie Davis, PHARM.D.
• Lisa M Dean, D.M.D.

• Community/Retail Pharmacy in Mountain Top, PA
• Providers in Mountain Top, 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 Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.