Fishtown Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482316 Issued in PA

Legal business name

FISHTOWN PHARMACY LLC

Doing business as

fishtown pharmacy

Practice address

1802 Frankford Ave
Philadelphia, PA 19125-2403

Phone

(267) 687-7562

NPI assigned

Dec 11, 2012

Organization subpart

No

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

Authorized official

Name

Binta Patel, PHARMD

Title

Owner

Phone

(267) 687-7562

Specialties & licenses 3

Addresses

Other names 1

• fishtown pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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

• Kris Hunsicker, PHARMD

  • Pharmacist
  • Philadelphia, PA
  • NPI 1023354248
  NPD
• Anna Wu

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Philadelphia, PA
  • NPI 1952991440
  NPD (past)

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1619212032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252403",
            "telephone_number": "267-687-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252403",
            "telephone_number": "267-687-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHTOWN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BINTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-687-7562",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482316",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "PA",
            "license": "PP482316",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "PA",
            "license": "PP482316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "fishtown pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Irene Fishman, CRNP
• Neil Owen Fishman, MD
• Rebecca H Fishman, MD
• Zachariah Fishoff, MSN
• Charles Krohn Fishpaw, PA-S
• David M Fiss, MD
• Kristi Helene Fissell, M.S.
• Diana Fissidas, NP
• Aspasia Fissikoudi, MD
• Nikola Madison Fistrovic, PA-C

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, 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 Nov 30, 2016; 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.