NPIMap

Organization Active NPI

RXD of Shenandoah

  • Community/Retail Pharmacy
  • Shenandoah, PA
National Provider Identifier
1629111380
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP413262L Issued in PA
Legal business name
RXD OF SHENANDOAH
Practice address
32 N Main St
Shenandoah, PA 17976-1777
Phone
(570) 462-2763
Fax
(570) 462-2097
NPI assigned
Feb 14, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Craig E Lehrman, RPH
Title
Vice President
Phone
(215) 927-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP413262L PA Primary

Addresses

Primary practice location

32 N Main St
Shenandoah, PA 17976-1777

Mailing address

PO Box 428
Collingswood, NJ 08108-0428
Phone (856) 858-9292

Other identifiers 3

IdentifierTypeStateIssuer
3945093OtherPANCPDP
PP413262LOtherPASTATE LICENSE
0008878390001MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
RXD Pharmacy of PA Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

32 N Main St
Shenandoah, PA 17976
Phone (570) 462-2763

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1629111380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081080428",
            "telephone_number": "856-858-9292",
            "fax_number": "856-858-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "SHENANDOAH",
            "state": "PA",
            "postal_code": "179761777",
            "telephone_number": "570-462-2763",
            "fax_number": "570-462-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RXD OF SHENANDOAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LEHRMAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-927-6700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP413262L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3945093",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PP413262L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008878390001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.