Active NPI
Ernest Cotilus III, RPH
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1902001365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP042149L
- Practice address
- 3 Crescent Dr FL 1
Philadelphia, PA 19112-1016 - Phone
- (215) 890-2000
- Fax
- (215) 890-9935
- NPI assigned
- Jun 18, 2007
- Reactivated
- May 8, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02911300 | NJ | |
| Pharmacist | 183500000X | RP042149L | PA | Primary |
Addresses
Primary practice location
3 Crescent Dr FL 1
Philadelphia, PA 19112-1016
Mailing address
26 Arbour LN
Sewell, NJ 08080-3701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02911300 | NJ | MD | Pharmacist |
| RP042149L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1902001365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 ARBOUR LN",
"city": "SEWELL",
"state": "NJ",
"postal_code": "080803701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 CRESCENT DR FL 1",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191121016",
"telephone_number": "215-890-2000",
"fax_number": "215-890-9935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTILUS",
"first_name": "ERNEST",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2019-05-08",
"deactivation_date": "2014-07-21",
"reactivation_date": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02911300",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP042149L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.