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Organization Active NPI

Philadelphia Department of Public Health Center Pharmacy #1

Doing business as Health Center #1 Pharmacy

  • Clinic Pharmacy
  • Philadelphia, PA
National Provider Identifier
1780752188
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PP481593 Issued in PA
Legal business name
PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #1
Doing business as
Health Center #1 Pharmacy
Practice address
500 S. Broad Street
Pharmacy
Philadelphia, PA 19146
Phone
(215) 685-6513
Fax
(215) 790-1651
NPI assigned
Dec 1, 2006
Last updated
Mar 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Authorized official

Name
Mr. Jeffrey T. Pender, RPH
Title
Director of Pharmaceutical Services
Phone
(215) 685-6864

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PP481593 PA Primary
Institutional Pharmacy 3336I0012X
Institutional Pharmacy 3336I0012X PA

Addresses

Primary practice location

500 S. Broad Street
Pharmacy
Philadelphia, PA 19146

Mailing address

500 S. Broad Street
Pharmacy/Basement
Philadelphia, PA 19146
Phone (215) 685-6864

Other identifiers 2

IdentifierTypeStateIssuer
1000076950093MedicaidPA
2081751OtherPK

Other names 1

  • HEALTH CENTER #1 PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Health Center No 523 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1780752188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S. BROAD STREET",
            "address_2": "PHARMACY/BASEMENT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19146",
            "telephone_number": "215-685-6864",
            "fax_number": "215-790-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S. BROAD STREET",
            "address_2": "PHARMACY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19146",
            "telephone_number": "215-685-6513",
            "fax_number": "215-790-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "PENDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACEUTICAL SERVICES",
        "authorized_official_telephone_number": "215-685-6864",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "PA",
            "license": "PP481593",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000076950093",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081751",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTH CENTER #1 PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEALTH CENTER #1 PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.