NPIMap

Organization Active NPI

Price Chopper Operating Co of PA Inc

  • Community/Retail Pharmacy
  • Wyoming, PA
National Provider Identifier
1710090295
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415625L Issued in PA
Legal business name
PRICE CHOPPER OPERATING CO OF PA INC
Practice address
1026 Wyoming Ave
Midway Shopping Center
Wyoming, PA 18644-1331
Phone
(570) 693-4572
Fax
(570) 693-4578
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Kathleen Bryant
Title
VP of Pharmacy
Phone
(518) 379-1122

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP415625L PA Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1026 Wyoming Ave
Midway Shopping Center
Wyoming, PA 18644-1331

Mailing address

461 Nott St
MB#202
Schenectady, NY 12308-1812
Phone (518) 379-1618

Other identifiers 2

IdentifierTypeStateIssuer
01793165MedicaidPA
2084944OtherPK

Other names 1

  • PRICE CHOPPER PHARMACY Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090720000012 PA Part B Supplier - Mass Immunization (Roster Biller Only) 4284786443 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyoming, PA; Wilkes Barre, PA; Matamoras, PA; Dunmore, PA; Montrose, PA
O20100930040423 PA DME Supplier - PharmacyDME Supplier - Grocery Store 4284786443 Practice locations: Wyoming, PA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

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

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
Price Chopper Operating Co of PA in1026 Wyoming Ave, Wyoming, PA 18644-1331(570) 693-4572 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Ostomy Supplies|Urological Supplies Accepts assignmentParticipating since Apr 19, 2005

National Provider Directory

National Provider Directory
Tax ID family
Price Chopper Operating Co5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1710090295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 NOTT ST",
            "address_2": "MB#202",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123081812",
            "telephone_number": "518-379-1618",
            "fax_number": "518-356-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 WYOMING AVE",
            "address_2": "MIDWAY SHOPPING CENTER",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441331",
            "telephone_number": "570-693-4572",
            "fax_number": "570-693-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRICE CHOPPER OPERATING CO OF PA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "518-379-1122"
    },
    "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": "PP415625L",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01793165",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2084944",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRICE CHOPPER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRICE CHOPPER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyoming, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.