NPIMap

Organization Active NPI

Weis Markets Inc

  • Community/Retail Pharmacy
  • Brodheadsville, PA
National Provider Identifier
1811920143
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WEIS MARKETS INC
Practice address
Route 209 and E Weir Lake Rd
Brodheadsville, PA 18322
Phone
(570) 992-5114
Fax
(570) 992-0788
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Jeffery Maltese, RPH
Title
Vice President Pharmacy
Phone
(570) 863-2809

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP415337L PA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

Route 209 and E Weir Lake Rd
Brodheadsville, PA 18322

Mailing address

1000 S 2ND St
PO Box 471
Sunbury, PA 17801-3318
Phone (570) 286-3623

Other identifiers 3

IdentifierTypeStateIssuer
1667992MedicaidPA
1007742100021MedicaidPA
3973674OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • WEIS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080915000562 PA Part B Supplier - Mass Immunization (Roster Biller Only) 8527134642 This NPI is an additional NPI on the enrollment
O20100930089043 PA DME Supplier - PharmacyDME Supplier - Grocery Store 8527134642 Practice locations: Brodheadsville, PA

National Provider Directory

National Provider Directory
Tax ID family
Weis Pharmacy 26128 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1811920143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S 2ND ST",
            "address_2": "PO BOX 471",
            "city": "SUNBURY",
            "state": "PA",
            "postal_code": "178013318",
            "telephone_number": "570-286-3623",
            "fax_number": "570-988-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 209 AND E WEIR LAKE RD",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "18322",
            "telephone_number": "570-992-5114",
            "fax_number": "570-992-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIS MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "MALTESE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "VICE PRESIDENT PHARMACY",
        "authorized_official_telephone_number": "570-863-2809",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP415337L",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1667992",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007742100021",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3973674",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEIS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brodheadsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.