NPIMap

Organization Active NPI

Old Roswell Holdings LLC

  • Long Term Care Pharmacy
  • Mechanicsburg, PA
National Provider Identifier
1669285151
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
OLD ROSWELL HOLDINGS LLC
Practice address
5225 Wilson LN
Mechanicsburg, PA 17055-6663
Phone
(717) 516-3103
Fax
(717) 516-3104
NPI assigned
Jan 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Tracy Eden
Title
Owner
Phone
(404) 459-8005

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

5225 Wilson LN
Mechanicsburg, PA 17055-6663

Mailing address

5064 Roswell Rd Ste A200
Atlanta, GA 30342-2252
Phone (404) 459-8005

Other names 1

  • Medicine Shoppe 2009 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CL Cressler Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1669285151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5064 ROSWELL RD STE A200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422252",
            "telephone_number": "404-459-8005",
            "fax_number": "404-256-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 WILSON LN",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170556663",
            "telephone_number": "717-516-3103",
            "fax_number": "717-516-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD ROSWELL HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "EDEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-459-8005"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe 2009",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.