Individual provider Active NPI

Vasilios Palengas, PHARMACIST

  • Pharmacist
  • Broomall, PA
National Provider Identifier
1710341334
Registry record updated Apr 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP034483L Issued in PA
Practice address
45 Media Line Rd Apt B4
Broomall, PA 19008-1213
Phone
(610) 203-0240
NPI assigned
Apr 9, 2016
Last updated
Apr 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP034483L PA Primary

Addresses

Primary practice location

45 Media Line Rd Apt B4
Broomall, PA 19008-1213

Mailing address

45 Media Line Rd Apt B4
Broomall, PA 19008-1213
Phone (610) 203-0240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RP034483LPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460160000000",
    "number": "1710341334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MEDIA LINE RD APT B4",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081213",
            "telephone_number": "610-203-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MEDIA LINE RD APT B4",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081213",
            "telephone_number": "610-203-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALENGAS",
        "first_name": "VASILIOS",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-09",
        "last_updated": "2016-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP034483L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2016; 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.