NPIMap

Organization Active NPI

Redner's Markets Inc.

Doing business as Redner's Pharmacy #46

  • Community/Retail Pharmacy
  • Hegins, PA
National Provider Identifier
1740399856
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415076L Issued in PA
Legal business name
REDNER'S MARKETS INC.
Doing business as
Redner's Pharmacy #46
Practice address
22 Forest Dr
Unit #3
Hegins, PA 17938-9013
Phone
(570) 680-3855
Fax
(570) 682-3196
NPI assigned
Aug 30, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Robert McDonough
Title
VP of Human Resources
Phone
(484) 248-5718

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PP415076L PA Primary

Addresses

Primary practice location

22 Forest Dr
Unit #3
Hegins, PA 17938-9013

Mailing address

22 Forest Dr
Unit #3
Hegins, PA 17938-9018
Phone (570) 682-3855

Other identifiers 1

IdentifierTypeStateIssuer
3970630OtherPANCPDP

Other names 1

  • Redner's Pharmacy #46 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110317000605 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3274653670 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shenandoah, PA; Palmyra, PA; Hegins, PA; Fredericksburg, PA; Leesport, PA
O20150909001110 PA DME Supplier - Pharmacy 3274653670 Practice locations: Hegins, 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
Redner's Pharmacy #4622 Forest Dr, Hegins, PA 17938-9018(570) 680-3855 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Nebulizer Equipment and/or Supplies|… Accepts assignmentParticipating since Jan 11, 2002

National Provider Directory

National Provider Directory
Tax ID family
Redners Markets Inc5 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.

Locations

22 Forest Dr
Unit 1
Hegins, PA 17938
Phone (570) 682-3862

22 Forest Dr
Unit 3
Hegins, PA 17938
Phone (570) 680-3855

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1740399856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 FOREST DR",
            "address_2": "UNIT #3",
            "city": "HEGINS",
            "state": "PA",
            "postal_code": "179389018",
            "telephone_number": "570-682-3855",
            "fax_number": "570-682-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FOREST DR",
            "address_2": "UNIT #3",
            "city": "HEGINS",
            "state": "PA",
            "postal_code": "179389013",
            "telephone_number": "570-680-3855",
            "fax_number": "570-682-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDNER'S MARKETS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MCDONOUGH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP OF HUMAN RESOURCES",
        "authorized_official_telephone_number": "484-248-5718",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP415076L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3970630",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redner's Pharmacy #46",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hegins, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.