Kinsleys Market of Tannersville Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KINSLEYS MARKET OF TANNERSVILLE INC

Practice address

107 Kinsley Dr
Brodheadsville, PA 18322-7800

Phone

(570) 992-2670

Fax

(570) 992-2877

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Miss Melissa Figueroa Rivera

Title

Third Party Administrator

Phone

(732) 521-8439

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 3

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

• Gary James Butz

  • Pharmacist
  • Brodheadsville, PA
  • NPI 1295321131
  NPD (past)
• Lynn Knappenberger, PHARMD

  • Pharmacist
  • Brodheadsville, PA
  • NPI 1225624141
  NPD (past)
• Christine Lorchak

  • Pharmacist
  • Brodheadsville, PA
  • NPI 1427644129
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1619002938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183220760",
            "telephone_number": "570-992-2670",
            "fax_number": "570-992-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KINSLEY DR",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183227800",
            "telephone_number": "570-992-2670",
            "fax_number": "570-992-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINSLEYS MARKET OF TANNERSVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA RIVERA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-521-8439",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3988017",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Izabella Busher Optometry LLC
• Fred Jacoby Jr., M.A.
• Dennis Janosczyk
• Michael Clarence Johnston, MHS, LPC, CA-C
• Joseph Keglovits III, PHARMD
• Kirit K Kothari MD PC
• Ardeana Y Kirkland, CRNP
• Lynn Knappenberger, PHARMD
• Joseph Kohm
• Ellyn Kravette, MSW, CADC,CFAE,CEAP

• Community/Retail Pharmacy in Brodheadsville, PA
• Providers in Brodheadsville, 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 Sep 3, 2015; 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.