Walter Cwietniewicz

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410688L Issued in PA

Legal business name

WALTER CWIETNIEWICZ

Doing business as

ELLIS PRESCRIPTION PHARMACY

Practice address

2441 Brown St
Philadelphia, PA 19130-1931

Phone

(215) 765-1903

Fax

(215) 236-6606

NPI assigned

Apr 5, 2006

Organization subpart

No

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

Authorized official

Name

Walter Cwietniewicz, BS

Title

RPH/Prop

Phone

(215) 765-1903

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ELLIS PRESCRIPTION PHARMACY Doing business as

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1841252772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 BROWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301931",
            "telephone_number": "215-765-1903",
            "fax_number": "215-236-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 BROWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301931",
            "telephone_number": "215-765-1903",
            "fax_number": "215-236-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER CWIETNIEWICZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "CWIETNIEWICZ",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "RPH/PROP",
        "authorized_official_telephone_number": "215-765-1903",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410688L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2086924",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1157371",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELLIS PRESCRIPTION PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert A Walsh, RN
• Therese Walsh
• Yvonne Jackson Walsh, SW
• Ciara Walshe
• Michael-Isaac Walshon, M.D.
• Alex Walter, PHARMD
• Annabelle Walter, MSW
• Danielle Lynne Walter, AU.D.
• James William Walter II, M.D.
• Jennifer Kay Walter, MD, PHD

• 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 Mar 1, 2017; 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.