Organization Active NPI

Rising Sun Pharmacy Inc

  • Community/Retail Pharmacy
  • Philadelphia, PA
National Provider Identifier
1679972780
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482458 Issued in PA
Legal business name
RISING SUN PHARMACY INC
Practice address
500 Devereaux Ave
A
Philadelphia, PA 19111-5767
Phone
(215) 613-6272
Fax
(215) 613-7093
NPI assigned
Aug 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Authorized official

Name
Mrs. Bindu Mathew, RPHNPI 1821317140
Title
Owner/Pharmacist
Phone
(267) 977-8259

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP482458 PA Primary

Addresses

Primary practice location

500 Devereaux Ave
A
Philadelphia, PA 19111-5767

Mailing address

9307 Laramie Rd
Philadelphia, PA 19115-2737
Phone (267) 977-8259

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240614001595 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3274076575 Practice locations: Philadelphia, PA
O20250418001171 PA DME Supplier - Pharmacy 3274076575 Practice locations: Philadelphia, 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
Rising Sun Pharmacy Inc500 Devereaux Ave, Philadelphia, PA 19111-5767(215) 613-6272 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Apr 22, 2024

National Provider Directory

National Provider Directory

Locations

500 Devereaux Ave
#A
Philadelphia, PA 19111
Phone (215) 613-6272

500 Devereaux Ave
Ste A
Philadelphia, PA 19111
Phone (215) 613-6272

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": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1679972780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9307 LARAMIE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152737",
            "telephone_number": "267-977-8259",
            "fax_number": "215-613-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DEVEREAUX AVE",
            "address_2": "A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115767",
            "telephone_number": "215-613-6272",
            "fax_number": "215-613-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING SUN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "BINDU",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "267-977-8259",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.