Endless Mountains Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481127 Issued in PA

Legal business name

ENDLESS MOUNTAINS PHARMACY INC

Doing business as

Endless Mountains Pharmacy
Wagner's Clifford Pharmacy

Practice address

1638 State Route 106
Clifford, PA 18413

Phone

(570) 222-7500

Fax

(570) 222-7503

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

William Scott Wagner, PHARM DNPI 1316969892

Title

Owner

Phone

(570) 222-7500

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• ENDLESS MOUNTAINS PHARMACY Doing business as
• Wagner's Clifford Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Scott Wagner, PHARMD

  • Pharmacist
  • Clifford, PA
  • NPI 1316969892
  NPD Authorized official
• Jared M Shayka, PHARMD

  • Pharmacist
  • Clifford, PA
  • NPI 1487894705
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1689694283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "CLIFFORD",
            "state": "PA",
            "postal_code": "184130189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 STATE ROUTE 106",
            "city": "CLIFFORD",
            "state": "PA",
            "postal_code": "18413",
            "telephone_number": "570-222-7500",
            "fax_number": "570-222-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDLESS MOUNTAINS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-222-7500",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018873230002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085895",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENDLESS MOUNTAINS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ENDLESS MOUNTAINS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wagner's Clifford Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Airgood, LPC
• Clifford Family Chiropractic
• Clifford Township Volunteer Fire Company
• Sandra Cosklo, DO
• Ladies Auxiliary of the Clifford Township Volunteer Fire Company
• Maxis Medical Services (endless mountain medical clinic)
• Jared M Shayka, PHARMD
• Russell Paul Swetter, DDS
• William Scott Wagner, PHARMD

• Community/Retail Pharmacy in Clifford, PA
• Providers in Clifford, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.