Walnut Street Apothecary Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482055 Issued in PA

Legal business name

WALNUT STREET APOTHECARY INC

Doing business as

Wynnefield Pharmacy

Practice address

1901 N 54TH St
Philadelphia, PA 19131-3221

Phone

(215) 222-2400

Fax

(215) 222-2442

NPI assigned

Aug 20, 2010

Organization subpart

No

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

Authorized official

Name

Paul Scota

Title

Owner

Phone

(610) 247-4122

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Wynnefield Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1760798359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W LEHIGH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191331640",
            "telephone_number": "215-225-7522",
            "fax_number": "215-225-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N 54TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191313221",
            "telephone_number": "215-222-2400",
            "fax_number": "215-222-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT STREET APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "SCOTA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-247-4122"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3994274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wynnefield Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason David Walls, MD
• Kathleen Elizabeth Walls, PSY.D.
• Theresa Ann Walls, MD
• Sarah Louise Walmsley, P.T.
• Walnut Psychotherapy Center
• Walnut Street Smiles PC
• Alesia Walsh, DMD
• Allison Louise Walsh
• Amy Elizabeth Walsh, CRNA
• Brian Walsh, D.O.

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.