Center Pharmacy of Erie Ave., Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410568L Issued in PA

Legal business name

CENTER PHARMACY OF ERIE AVE., INC

Practice address

516 W Erie Ave
Philadelphia, PA 19140-4535

Phone

(215) 225-0998

Fax

(215) 225-2781

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Philip M Lubaroff, R.PH.

Title

President

Phone

(215) 225-0998

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1790836559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404535",
            "telephone_number": "215-225-0998",
            "fax_number": "215-225-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404535",
            "telephone_number": "215-225-0998",
            "fax_number": "215-225-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER PHARMACY OF ERIE AVE., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "LUBAROFF",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-225-0998",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "PP410568L",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410568L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009311780001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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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 Sep 2, 2016; 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.