Life Tree Pharmacy Services Incorporated

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PP481454 Issued in PA

Legal business name

LIFE TREE PHARMACY SERVICES INCORPORATED

Practice address

5 Blue Heron Dr
Collegeville, PA 19426-2057

Phone

(610) 489-6640

Fax

(610) 489-6645

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Mark Taglianetti

Title

President

Phone

(610) 489-6640

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Life Tree Pharmacy Services Incorporated Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1760428684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BLUE HERON DR",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262057",
            "telephone_number": "610-489-6640",
            "fax_number": "610-489-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BLUE HERON DR",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262057",
            "telephone_number": "610-489-6640",
            "fax_number": "610-489-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TREE PHARMACY SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "TAGLIANETTI",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-489-6640"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "PA",
            "license": "PP481454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013015200001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085292",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Tree Pharmacy Services Incorporated",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life Tree Pharmacy Services Incorporated",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rongshan Li, MD
• Melanie Liberatore, NP-C
• Catherine Dulay Lichtenstein, DDS
• Haven Odette Liegel
• Life Tree Pharmacy Services Inc
• Catina S Light
• Lighthouse Healthcare LLC
• Andrew Moss Lippa, M.D., PH.D.
• Debbie Sharrow Lombardi, M.S.
• Sarah Longenberger

• Long Term Care Pharmacy in Collegeville, PA
• Providers in Collegeville, PA by specialty
• Long Term Care Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.