Burrell Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410511L Issued in PA

Legal business name

BURRELL PHARMACY, INC

Doing business as

Pisone's Pharmacy

Practice address

1908 River Rd
North Apollo, PA 15673

Phone

(724) 478-4061

Fax

(724) 478-1461

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By 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

Alexander J Micklow, R.PH.

Title

Secretary

Phone

(724) 478-4061

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pisone's Pharmacy Doing business as

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619052123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 RIVER RD",
            "address_2": "PO BOX 36",
            "city": "NORTH APOLLO",
            "state": "PA",
            "postal_code": "15673",
            "telephone_number": "724-478-4061",
            "fax_number": "724-478-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 RIVER RD",
            "city": "NORTH APOLLO",
            "state": "PA",
            "postal_code": "15673",
            "telephone_number": "724-478-4061",
            "fax_number": "724-478-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURRELL PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICKLOW",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "724-478-4061",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410511L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3938086",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019711310002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pisone's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew K Brush, DC
• Trisha Clark, RN
• Chris H Eddins Jr., DC
• Fidel Velez M D
• Darrick S Mason, DC
• Oklahoma Vol Fire Dept #1

• Community/Retail Pharmacy in North Apollo, PA
• Providers in North Apollo, 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 22, 2020; 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.