NPIMap

Organization Active NPI

Custom Care Pharmacy

  • Community/Retail Pharmacy
  • Milton, PA
National Provider Identifier
1891075537
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482213 Issued in PA
Legal business name
CUSTOM CARE PHARMACY
Doing business as
Custom Care Pharmacy
Practice address
57 S Front St
Milton, PA 17847-1110
Phone
(570) 246-5700
Fax
(570) 246-5705
NPI assigned
Aug 25, 2011
Last updated
Aug 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Authorized official

Name
Adam RosinskiNPI 1437427218
Title
President / Pharmacy Manager
Phone
(570) 850-9988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PP482213 PA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

57 S Front St
Milton, PA 17847-1110

Mailing address

57 S Front St
Milton, PA 17847-1110
Phone (570) 246-5700

Other identifiers 1

IdentifierTypeStateIssuer
2132654OtherPK

Other names 1

  • Custom Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120229000902 PA DME Supplier - Pharmacy 3577721026 Practice locations: Milton, PA
O20131015001483 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3577721026 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sunbury, PA; Milton, PA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Custom Care Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440115200000",
    "number": "1891075537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 S FRONT ST",
            "city": "MILTON",
            "state": "PA",
            "postal_code": "178471110",
            "telephone_number": "570-246-5700",
            "fax_number": "570-524-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 S FRONT ST",
            "city": "MILTON",
            "state": "PA",
            "postal_code": "178471110",
            "telephone_number": "570-246-5700",
            "fax_number": "570-246-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2015-08-21",
        "status": "A",
        "authorized_official_last_name": "ROSINSKI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT / PHARMACY MANAGER",
        "authorized_official_telephone_number": "570-850-9988"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482213",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132654",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.