NPIMap

Organization Active NPI

Peck Group Inc.

Doing business as Tipton Pharmacy

  • Community/Retail Pharmacy
  • Tipton, PA
National Provider Identifier
1609964816
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415132L Issued in PA
Legal business name
PECK GROUP INC.
Doing business as
Tipton Pharmacy
Practice address
4384 E. Pleasant Valley Blvd. Ste 1
Tipton, PA 16684
Phone
(814) 684-7979
Fax
(814) 684-7647
NPI assigned
Oct 11, 2006
Last updated
May 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Charles C Peck, R.PH.NPI 1063446664
Title
Owner Pharmacist
Phone
(814) 684-7979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP415132L PA Primary

Addresses

Primary practice location

4384 E. Pleasant Valley Blvd. Ste 1
Tipton, PA 16684

Mailing address

P.O. Box 40
Tipton, PA 16684
Phone (814) 684-7979

Other identifiers 2

IdentifierTypeStateIssuer
001564340-0001MedicaidPA
PP415132LOtherPASTATE PHARMACY LICENSE

Other names 1

  • Tipton Pharmacy Doing business as

National Provider Directory

National Provider Directory

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1609964816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 40",
            "city": "TIPTON",
            "state": "PA",
            "postal_code": "16684",
            "telephone_number": "814-684-7979",
            "fax_number": "814-684-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4384 E. PLEASANT VALLEY BLVD. STE 1",
            "city": "TIPTON",
            "state": "PA",
            "postal_code": "16684",
            "telephone_number": "814-684-7979",
            "fax_number": "814-684-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECK GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "814-684-7979",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP415132L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001564340-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "PP415132L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tipton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tipton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.