NPIMap

Organization Active NPI

Pennsylvania Department of Public Welfare

  • Pharmacy
  • Ebensburg, PA
National Provider Identifier
1831132174
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP417043L Issued in PA
Legal business name
PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
Practice address
4501 Admiral Peary Hwy
Ebensburg, PA 15931-4332
Phone
(814) 472-0495
Fax
(814) 472-0572
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Christine Griffith
Title
Chief Pharmacist
Phone
(814) 472-0498

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PP417043L PA Primary
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

4501 Admiral Peary Hwy
Ebensburg, PA 15931-4332

Mailing address

4501 Admiral Peary Hwy
Ebensburg, PA 15931-4332

Other identifiers 2

IdentifierTypeStateIssuer
0743150MedicaidPA
3951969OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Ebensburg Center Pharmacy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2185069Ebensburg Center4501 Admiral Peary Highway, Ebensburg, PA 15931Certificate of waiverMay 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Haverford State Hosp16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1831132174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 ADMIRAL PEARY HWY",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 ADMIRAL PEARY HWY",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314332",
            "telephone_number": "814-472-0495",
            "fax_number": "814-472-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CHIEF PHARMACIST",
        "authorized_official_telephone_number": "814-472-0498"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP417043L",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0743150",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3951969",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ebensburg Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.