Independent Pharmacies Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481967 Issued in PA

Legal business name

INDEPENDENT PHARMACIES INCORPORATED

Doing business as

Centennial pharmacy southphilly

Practice address

2036-38 South 3Rd Street
Philadelphia, PA 19148

Phone

(215) 468-2111

Fax

(215) 468-0387

NPI assigned

Nov 11, 2009

Organization subpart

No

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

Authorized official

Name

Joseph Dymowski

Title

Owner/President

Phone

(215) 468-2111

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Centennial pharmacy southphilly Doing business as

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1790012763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37544",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191487544",
            "telephone_number": "215-468-2111",
            "fax_number": "215-468-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036-38 SOUTH 3RD STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "215-468-2111",
            "fax_number": "215-468-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHARMACIES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "DYMOWSKI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "215-468-2111"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023943640001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2122483",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial pharmacy southphilly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Jan 7, 2021; 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.