Penntrust Medical Holdings LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482537 Issued in PA

Legal business name

PENNTRUST MEDICAL HOLDINGS LLC

Practice address

175 S Main St
Unit 2
Yardley, PA 19067-1623

Phone

(267) 573-4555

Fax

(267) 573-4966

NPI assigned

Jan 15, 2015

Organization subpart

No

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

Authorized official

Name

Brian William Rogers, PHARMDNPI 1194114017

Title

President

Phone

(267) 532-7073

Specialties & licenses 1

Addresses

Other names 1

• Yardley Pharmacy & Supply Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian William Rogers, PHARMD

  • Pharmacist
  • Yardley, PA
  • NPI 1194114017
  NPD (past) Authorized official

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1851780795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S MAIN ST",
            "address_2": "UNIT 2",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190671623",
            "telephone_number": "267-573-4555",
            "fax_number": "267-573-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S MAIN ST",
            "address_2": "UNIT 2",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190671623",
            "telephone_number": "267-573-4555",
            "fax_number": "267-573-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNTRUST MEDICAL HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-532-7073",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yardley Pharmacy & Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Penn Medical Pharmacy LLC
• Penncare Bucks County - Family Medicine
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania CVS Pharmacy, L.L.C.
• Kristen Marie Pepitone, MS, OTR/L
• Jennifer M Perez
• Marla Maria Perez, MD
• Lindsay Perlman, PA
• Laura Beth Peskin, CRNP

• All providers in Yardley, PA
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.