Brundage Pharmacies Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

PP482647 Issued in PA

Legal business name

BRUNDAGE PHARMACIES INC.

Doing business as

Brundage's Lake Region Pharmacy

Practice address

2489 Route 6
Hawley, PA 18428-6078

Phone

(570) 390-7655

Fax

(570) 390-7657

NPI assigned

May 16, 2016

Last updated

May 16, 2016By 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

Michael BrundageNPI 1639173032

Title

President

Phone

(570) 488-7979

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brundage's Lake Region Pharmacy Doing business as

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.

• Michael L Brundage, PHARM.D.

  • Pharmacist
  • Waymart, PA
  • NPI 1639173032
  NPD Authorized official

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1609223197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "WAYMART",
            "state": "PA",
            "postal_code": "184720398",
            "telephone_number": "570-488-7979",
            "fax_number": "570-488-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 ROUTE 6",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184286078",
            "telephone_number": "570-390-7655",
            "fax_number": "570-390-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNDAGE PHARMACIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "BRUNDAGE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-488-7979"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP482647",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160099",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brundage's Lake Region Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Lynn Black, FNP-C
• Emily Blasi
• Julia Catherine Blaskiewicz, PT, DPT
• Blissful Mind Counseling Services LLC
• Donald O. Broughton, D.C.
• Samantha Kimberly Burkhardt, CRC, LPC
• Christine Carlozzi, OT
• Moira Kelcey Castaldi, DPT
• Karen Chabak, MSPT
• Elizabeth Ciaravino, PH D

• Pharmacy in Hawley, PA
• Providers in Hawley, PA by specialty
• Pharmacy in Pennsylvania

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