NPIMap

Organization Active NPI

Trustees of the University of Pennsylvania

Doing business as Hospital of the University of Pennylvania- Valley Forge Phar

  • Pharmacy
  • Berwyn, PA
National Provider Identifier
1659829877
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP482675 Issued in PA
Legal business name
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Doing business as
Hospital of the University of Pennylvania- Valley Forge Phar
Practice address
1001 Chesterbrook Blvd
1St Floor
Berwyn, PA 19312-3805
Phone
(610) 576-7545
Fax
(610) 576-7560
NPI assigned
Sep 16, 2016
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Richard Demers
Title
Director of Pharmacy
Phone
(215) 796-2085

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP482675 PA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1001 Chesterbrook Blvd
1St Floor
Berwyn, PA 19312-3805

Mailing address

1001 Chesterbrook Blvd
1St Floor
Berwyn, PA 19312-3805
Phone (610) 576-7545

Other identifiers 2

IdentifierTypeStateIssuer
2164003OtherPK
1001258770290MedicaidPA

Other names 1

  • Hospital of the University of Pennylvania- Valley Forge Phar Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170824003176 PA DME Supplier - Pharmacy 2062326507 Practice locations: Berwyn, PA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Trustees of the University of Penns1001 Chesterbrook Blvd, Berwyn, PA 19312-3805(610) 576-7545 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jul 1, 2006

National Provider Directory

National Provider Directory
Tax ID family
Hup Dept Pathology la44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

1001 Chesterbrook Blvd
Fl 1
Berwyn, PA 19312
Phone (610) 576-7500

Ownership & related parties

All facility ownership & control disclosures 17

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Medicine Princeton Medical CenterPlainsboro, NJ, CCN 310010 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
Lancaster General HospitalLancaster, PA, CCN 390100 Hospital 5% Or Greater Indirect Ownership Interest Aug 1, 2015
Hospital of the University of PennsylvaniaPhiladelphia, PA, CCN 390111 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 18, 2007
Oct 18, 2007
Hospital of the University of PennsylvaniaPhiladelphia, PA, CCN 39T111 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 16, 2007
Nov 16, 2017
The Pennsylvania Hospital of the University of Pennsylvania Health SysPhiladelphia, PA, CCN 390226 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 30, 1997
The Pennsylvania Hospital of the University of Pennsylvania Health SysPhiladelphia, PA, CCN 39S226 Hospital 5% Or Greater Direct Ownership Interest Apr 30, 1997
Penn Presbyterian Medical CenterPhiladelphia, PA, CCN 390223 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 13, 1995
Penn Medicine | Good Shepherd RehabilitationPhiladelphia, PA, CCN 392050 Hospital Other (49%) Jul 1, 2019
Chester County HospitalWest Chester, PA, CCN 390179 Hospital 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2013
Penn Medicine Princeton Medical Center Acute Rehabilitation CenterPlainsboro, NJ, CCN 31T010 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
Penn Medicine Princeton House Behavioral HealthPlainsboro, NJ, CCN 31S010 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
Lancaster Behavioral Health HospitalLancaster, PA, CCN 394055 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 7, 2014
Rittenhouse Post AcutePhiladelphia, PA, CCN 395749 Skilled nursing facility Adp of the SNF Sep 12, 2024
Penn Medicine Home HealthBala Cynwyd, PA, CCN 397125 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jun 13, 1995
Penn Medicine Home Health Princeton HealthPrinceton, NJ, CCN 317045 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
Penn Medicine Hospice Princeton HealthPrinceton, NJ, CCN 311506 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
Penn Medicine HospiceBala Cynwyd, PA, CCN 391501 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997

Owned or controlled facilities with NPI records 20

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1659829877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CHESTERBROOK BLVD",
            "address_2": "1ST FLOOR",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193123805",
            "telephone_number": "610-576-7545",
            "fax_number": "610-576-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CHESTERBROOK BLVD",
            "address_2": "1ST FLOOR",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193123805",
            "telephone_number": "610-576-7545",
            "fax_number": "610-576-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "DEMERS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "215-796-2085"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP482675",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001258770290",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospital of the University of Pennylvania- Valley Forge Phar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berwyn, PA

Sources for this page

Verify at the official NPI Registry.