William C Kennedy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410693L Issued in PA

Legal business name

WILLIAM C KENNEDY

Doing business as

The Medicine Shoppe

Practice address

56 Mauch Chunk St
Tamaqua, PA 18252-1405

Phone

(570) 668-6366

Fax

(570) 668-9019

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

William Charles Kennedy

Title

Owner

Phone

(570) 668-6366

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Medicine Shoppe Doing business as

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1861419574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 MAUCH CHUNK ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182521405",
            "telephone_number": "570-668-6366",
            "fax_number": "570-668-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MAUCH CHUNK ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182521405",
            "telephone_number": "570-668-6366",
            "fax_number": "570-668-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C KENNEDY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-668-6366"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410693L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007450860002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3937046",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC NUMBER",
            "identifier": "PP410693L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyssa Turk, MA, LPC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3634)
• Wal-Mart Stores East, L.P. (Vision Center 30-3634)
• Catherine Wang, MD
• Joseph Mark Washko, D.C.
• Wendy Willing-Hall, MS, NCC
• Shana Yourey
• Aron Joseph Zarowsky, PA

• Community/Retail Pharmacy in Tamaqua, PA
• Providers in Tamaqua, 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 7, 2023; 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.