Organization Active NPI

Nanticoke Pharmacy LLC

  • Community/Retail Pharmacy
  • Seaford, DE
National Provider Identifier
1679878185
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
A3-0000927 Issued in DE
Legal business name
NANTICOKE PHARMACY LLC
Doing business as
Nanticoke Pharmacy, LLC
Practice address
1609A Middleford Rd
Seaford, DE 19973-3617
Phone
(302) 536-7464
Fax
(302) 536-7667
NPI assigned
Jan 13, 2011
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Bimal DasNPI 1154629764
Title
Owner/Pic
Phone
(954) 570-9948

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X A3-0000927 DE Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

1609A Middleford Rd
Seaford, DE 19973-3617

Mailing address

1609A Middleford Rd
Seaford, DE 19973-3617
Phone (302) 536-7464

Other identifiers 2

IdentifierTypeStateIssuer
1679878185MedicaidDE
2128634OtherPK

Other names 1

  • NANTICOKE PHARMACY, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170901003084 DE Part B Supplier - Mass Immunization (Roster Biller Only) 8628294352 Practice locations: Seaford, DE

National Provider Directory

National Provider Directory

Locations

1609 Middleford Rd
#A
Seaford, DE 19973
Phone (302) 536-7464

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1679878185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609A MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733617",
            "telephone_number": "302-536-7464",
            "fax_number": "302-536-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609A MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733617",
            "telephone_number": "302-536-7464",
            "fax_number": "302-536-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANTICOKE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "DAS",
        "authorized_official_first_name": "BIMAL",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "954-570-9948"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DE",
            "license": "A3-0000927",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679878185",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128634",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NANTICOKE PHARMACY, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seaford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.