NPIMap

Organization Active NPI

Creative Pharmacy Solutions East LLC

Doing business as Pharmacy Innovations

  • Pharmacy
  • Virginia Beach, VA
National Provider Identifier
1700894649
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
0201003136 Issued in VA
Legal business name
CREATIVE PHARMACY SOLUTIONS EAST LLC
Doing business as
Pharmacy Innovations
Practice address
4001 Virginia Beach Blvd Ste 110
Virginia Beach, VA 23452-1759
Phone
(757) 934-0533
Fax
(757) 228-3991
NPI assigned
Aug 4, 2006
Last updated
Jul 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Richard Moon
Title
Owner
Phone
(716) 720-5121

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 0201003136 VA Primary
Community/Retail Pharmacy 3336C0003X NU
Mail Order Pharmacy 3336M0002X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

4001 Virginia Beach Blvd Ste 110
Virginia Beach, VA 23452-1759

Mailing address

2535 Johns PL
Jamestown, NY 14701-9210
Phone (716) 720-5121

Other identifiers 2

IdentifierTypeStateIssuer
2154895OtherPK
1700894649MedicaidVA

Other names 1

  • Pharmacy Innovations Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Creative Pharmacy Solutions East LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2535 Johns Pl
Jamestown, NY 14701

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1700894649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 JOHNS PL",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019210",
            "telephone_number": "716-720-5121",
            "fax_number": "716-708-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 VIRGINIA BEACH BLVD STE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521759",
            "telephone_number": "757-934-0533",
            "fax_number": "757-228-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE PHARMACY SOLUTIONS EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-720-5121"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003136",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154895",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700894649",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy Innovations",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pharmacy Innovations",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.