Organization Active NPI

Bills Shursave Pharmacy

  • Community/Retail Pharmacy
  • Moscow, PA
National Provider Identifier
1689619801
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415521L Issued in PA
Legal business name
BILLS SHURSAVE PHARMACY
Practice address
RR 6 Box 6220
Rte 502 Daleville
Moscow, PA 18444-9062
Phone
(570) 842-7461
Fax
(570) 842-6520
NPI assigned
Jun 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Denise Warhola, RPH
Title
Phcy MGR
Phone
(570) 842-7848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP415521L PA Primary

Addresses

Primary practice location

RR 6 Box 6220
Rte 502 Daleville
Moscow, PA 18444-9062

Mailing address

RR 6 Box 6220
Rte 502 Daleville
Moscow, PA 18444-9062

Other identifiers 2

IdentifierTypeStateIssuer
17474494490001MedicaidPA
3975743OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930024618 PA DME Supplier - PharmacyDME Supplier - Grocery Store 7012038425 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Covington Township, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689619801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 6 BOX 6220",
            "address_2": "RTE 502 DALEVILLE",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "184449062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 6 BOX 6220",
            "address_2": "RTE 502 DALEVILLE",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "184449062",
            "telephone_number": "570-842-7461",
            "fax_number": "570-842-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLS SHURSAVE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARHOLA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PHCY MGR",
        "authorized_official_telephone_number": "570-842-7848",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP415521L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17474494490001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3975743",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.