Individual provider Active NPI

Ernest Cotilus III, RPH

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1902001365
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP042149L Issued in PA
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

Updated by the provider on May 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
28RI02911300NJMDPharmacist
RP042149LPAMDPharmacist

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.

Verify at the official NPI Registry.