Skippack RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP412308L Issued in PA

Legal business name

SKIPPACK RX LLC

Doing business as

Skippack Pharmacy

Practice address

4118 W Skippack Pike
Skippack, PA 19474

Phone

(610) 584-6544

Fax

(610) 584-4271

NPI assigned

May 2, 2016

Last updated

Jan 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anitha Rao Mandava

Title

Pharmacy Manager

Phone

(610) 584-6544

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Skippack Pharmacy Doing business as

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1841645462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4118 W SKIPPACK PIKE",
            "address_2": "PO BOX 797",
            "city": "SKIPPACK",
            "state": "PA",
            "postal_code": "19474",
            "telephone_number": "610-584-6544",
            "fax_number": "610-584-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4118 W SKIPPACK PIKE",
            "city": "SKIPPACK",
            "state": "PA",
            "postal_code": "19474",
            "telephone_number": "610-584-6544",
            "fax_number": "610-584-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIPPACK RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "MANDAVA",
        "authorized_official_first_name": "ANITHA RAO",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "610-584-6544"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412308L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103221699-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159578",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skippack Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Skippack, PA
• Providers in Skippack, 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 Jan 24, 2018; 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.