Bracey's Mount Pocono, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481373 Issued in PA

Legal business name

BRACEY'S MOUNT POCONO, INC.

Doing business as

Bill's Shoprite Pharmacy Mt. Pocono

Practice address

89 State Route 940
Mount Pocono, PA 18344-1426

Phone

(570) 839-5340

NPI assigned

Oct 26, 2006

Last updated

Mar 30, 2011By 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

Melissa Figueroa-Rivera

Title

Third Party Administrator

Phone

(732) 521-8439

Specialties & licenses 1

Addresses

Other names 1

• Bill's Shoprite Pharmacy Mt. Pocono Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Stephen Flyte

  • Pharmacist
  • Mount Pocono, PA
  • NPI 1326409319
  NPD (past)
• Paula Ann Keller

  • Pharmacist
  • Mount Pocono, PA
  • NPI 1730775917
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1851476949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 DRINKER TPKE",
            "city": "COVINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184447947",
            "telephone_number": "570-842-7461",
            "fax_number": "570-842-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 STATE ROUTE 940",
            "city": "MOUNT POCONO",
            "state": "PA",
            "postal_code": "183441426",
            "telephone_number": "570-839-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRACEY'S MOUNT POCONO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA-RIVERA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-521-8439"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bill's Shoprite Pharmacy Mt. Pocono",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Makenzie Elizabeth Batt
• Lori Eileen Bertanzetti, LCSW
• Best Vision Center Inc
• Paul W. Bisio, D.O.
• Sylvia M. Bolock, D.O.
• Lisa Brown, MS
• William Michael Burkit, MA, ATR-BC, LPC
• Ishima Q Butler, BS
• Debora T Cantel, D.C.
• Margurita M Carter, MDIV, PHD,

• Community/Retail Pharmacy in Mount Pocono, PA
• Providers in Mount Pocono, 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 30, 2011; 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.