Express Discount Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

A3-0001000 Issued in DE

Legal business name

EXPRESS DISCOUNT PHARMACY LLC

Doing business as

Express Discount Pharmacy

Practice address

4528 Kirkwood Hwy Ste a
Wilmington, DE 19808-5126

Phone

(302) 575-9891

Fax

(302) 575-9893

NPI assigned

Mar 17, 2016

Organization subpart

No

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

Authorized official

Name

Pavithran GujjaNPI 1184758849

Title

Pharmacist in-Charge/Member

Phone

(302) 575-9891

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Express Discount Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in DE2 enrollments

Enrollment records 2

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

Locations

Practitioners 1

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.

• Pavithran Gujja, R.PH

  • Pharmacist
  • Wilmington, DE
  • NPI 1184758849
  NPD Authorized official

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1760843734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4528 KIRKWOOD HWY",
            "address_2": "STE A",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085126",
            "telephone_number": "302-575-9891",
            "fax_number": "302-575-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4528 KIRKWOOD HWY STE A",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085126",
            "telephone_number": "302-575-9891",
            "fax_number": "302-575-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS DISCOUNT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "GUJJA",
        "authorized_official_first_name": "PAVITHRAN",
        "authorized_official_title_or_position": "PHARMACIST IN-CHARGE/MEMBER",
        "authorized_official_telephone_number": "302-575-9891"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DE",
            "license": "A3-0001000",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760843734",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158882",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Express Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Express Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Community/Retail Pharmacy in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.