NPIMap

Organization Active NPI

Lords Valley Village Pharmacy Inc

  • Community/Retail Pharmacy
  • Hawley, PA
National Provider Identifier
1750470308
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP414053L Issued in PA
Legal business name
LORDS VALLEY VILLAGE PHARMACY INC
Doing business as
Lords Valley Village Pharmacy Inc
Practice address
658 Route 739
Suite 5
Hawley, PA 18428-6086
Phone
(570) 775-9555
Fax
(570) 775-9593
NPI assigned
Oct 12, 2006
Last updated
Nov 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Authorized official

Name
Dennis Dougherty, RPHNPI 1386174746
Title
President
Phone
(570) 499-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PP414053L PA Primary

Addresses

Primary practice location

658 Route 739
Suite 5
Hawley, PA 18428-6086

Mailing address

658 Route 739
Suite 5
Hawley, PA 18428-6086
Phone (570) 775-9555

Other identifiers 2

IdentifierTypeStateIssuer
2086573OtherPK
001126769-0003MedicaidPA

Other names 1

  • LORDS VALLEY VILLAGE PHARMACY INC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1750470308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 ROUTE 739",
            "address_2": "SUITE 5",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184286086",
            "telephone_number": "570-775-9555",
            "fax_number": "570-775-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 ROUTE 739",
            "address_2": "SUITE 5",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184286086",
            "telephone_number": "570-775-9555",
            "fax_number": "570-775-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORDS VALLEY VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-499-1900",
        "authorized_official_credential": "RPH"
    },
    "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": "PP414053L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2086573",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001126769-0003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LORDS VALLEY VILLAGE PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hawley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.