Active NPI
Charles Anthony Mikulka Jr.
- Pharmacist
- Mount Joy, PA
National Provider Identifier
1740884683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP040215L
- Practice address
- 441 W Main St
Mount Joy, PA 17552-1228 - Phone
- (717) 653-5298
- Fax
- (717) 653-2849
- NPI assigned
- Nov 22, 2020
- Last updated
- Sep 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP040215L | PA | Primary |
Addresses
Primary practice location
441 W Main St
Mount Joy, PA 17552-1228
Mailing address
441 W Main St
Mount Joy, PA 17552-1228
Phone (717) 653-5298
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP040215L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1740884683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 W MAIN ST",
"city": "MOUNT JOY",
"state": "PA",
"postal_code": "175521228",
"telephone_number": "717-653-5298",
"fax_number": "717-653-2849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 W MAIN ST",
"city": "MOUNT JOY",
"state": "PA",
"postal_code": "175521228",
"telephone_number": "717-653-5298",
"fax_number": "717-653-2849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKULKA",
"first_name": "CHARLES",
"middle_name": "ANTHONY",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-22",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP040215L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Joy, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.