NPIMap

Organization Active NPI

Southmoore Pharmacy LLC

Doing business as SouthMoore Pharmacy

  • Community/Retail Pharmacy
  • Bath, PA
National Provider Identifier
1811254493
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482196 Issued in PA
Legal business name
SOUTHMOORE PHARMACY LLC
Doing business as
SouthMoore Pharmacy
Practice address
2453 Plaza CT Ste a
Bath, PA 18014-8762
Phone
(484) 287-6337
Fax
(484) 287-6340
NPI assigned
Apr 19, 2012
Last updated
Jan 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Authorized official

Name
Dawn WeberNPI 1487750337
Title
Partner
Phone
(484) 287-6337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP482196 PA Primary

Addresses

Primary practice location

2453 Plaza CT Ste a
Bath, PA 18014-8762

Mailing address

2453 Plaza CT Ste a
Bath, PA 18014
Phone (484) 287-6337

Other identifiers 1

IdentifierTypeStateIssuer
3997181OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • SouthMoore Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

2453 Plaza Ct
Ste A
Bath, PA 18014
Phone (484) 287-6337

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1811254493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2453 PLAZA CT STE A",
            "city": "BATH",
            "state": "PA",
            "postal_code": "18014",
            "telephone_number": "484-287-6337",
            "fax_number": "484-287-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2453 PLAZA CT STE A",
            "city": "BATH",
            "state": "PA",
            "postal_code": "180148762",
            "telephone_number": "484-287-6337",
            "fax_number": "484-287-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHMOORE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "484-287-6337"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3997181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthMoore Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bath, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.