Blandon Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481887 Issued in PA

Legal business name

BLANDON PHARMACY LLC

Practice address

104 Anna Ave
Blandon, PA 19510-9310

Phone

(610) 944-8899

Fax

(610) 944-0888

NPI assigned

Feb 10, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Adnan Shubbar, R.PH.NPI 1164514261

Title

Manager

Phone

(610) 504-1316

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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

• Adnan Shubbar, R.PH.

  • Pharmacist
  • Glenside, PA
  • NPI 1164514261
  NPD Authorized official
• Sarah Ahearn

  • Pharmacist
  • Blandon, PA
  • NPI 1467054940
  NPD (past)
• Joseph Dantas

  • Pharmacist
  • Blandon, PA
  • NPI 1679028898
  NPD (past)

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1902045255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ANNA AVE",
            "city": "BLANDON",
            "state": "PA",
            "postal_code": "195109310",
            "telephone_number": "610-944-8899",
            "fax_number": "610-944-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ANNA AVE",
            "city": "BLANDON",
            "state": "PA",
            "postal_code": "195109310",
            "telephone_number": "610-944-8899",
            "fax_number": "610-944-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANDON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "SHUBBAR",
        "authorized_official_first_name": "ADNAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "610-504-1316",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022690430001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Affordable Dental Solutions, LLC
• Sarah Ahearn
• Berks County Recovery Transitional Services, LLC
• Berks Family Physicians, P.C.
• Blandon Community Ambulance Assn Inc.
• Gaynelle Clarette Bloh, BCBA
• Gregory Scott Bobal, DC
• Kim Marie Burt, M.S.
• Matthew J Cambria, DMD
• Yi Hsuan Chu

• Community/Retail Pharmacy in Blandon, PA
• Providers in Blandon, 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 Jun 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.