Organization Active NPI

Shafers Pharmacy LLC

  • Community/Retail Pharmacy
  • Tamaqua, PA
National Provider Identifier
1629094586
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP412251L Issued in PA
Legal business name
SHAFERS PHARMACY LLC
Practice address
408 E Broad St
Tamaqua, PA 18252-2108
Phone
(570) 668-0290
Fax
(570) 668-2454
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Lee Shafer, RPH
Title
Member Pharmacist
Phone
(570) 668-0290

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP412251L PA Primary

Addresses

Primary practice location

408 E Broad St
Tamaqua, PA 18252-2108

Mailing address

408 E Broad St
Tamaqua, PA 18252-2108
Phone (570) 668-0290

Other identifiers 2

IdentifierTypeStateIssuer
2080909OtherPK
001928936001MedicaidPA

Other names 1

  • SHAFERS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100108000789 PA Part B Supplier - Mass Immunization (Roster Biller Only) 1254472582 Practice locations: Tamaqua, PA
O20100930054445 PA DME Supplier - Pharmacy 1254472582 Practice locations: Tamaqua, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Shafers Pharmacy LLC408 E Broad St, Tamaqua, PA 18252-2108(570) 668-0290 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Insulin Infusion Pumps and/or Supplies|Ostomy Supplies|Nebulizer Equipment and/or Supplies Does not accept assignmentParticipating since Sep 5, 2002

National Provider Directory

National Provider Directory

Locations

11 Center St
Tamaqua, PA 18252
Phone (570) 668-0290

408 E Broad St
Tamaqua, PA 18252
Phone (570) 668-0290

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1629094586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E BROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182522108",
            "telephone_number": "570-668-0290",
            "fax_number": "570-668-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E BROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182522108",
            "telephone_number": "570-668-0290",
            "fax_number": "570-668-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFERS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "MEMBER PHARMACIST",
        "authorized_official_telephone_number": "570-668-0290",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412251L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2080909",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001928936001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHAFERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHAFERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tamaqua, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.