Organization Active NPI

Thiraj LLC

  • Community/Retail Pharmacy
  • Sellersville, PA
National Provider Identifier
1902811508
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP414107L Issued in PA
Legal business name
THIRAJ LLC
Practice address
218 S Main St
Sellersville, PA 18960-2529
Phone
(215) 257-9077
Fax
(215) 453-0633
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
Jignesh PatelNPI 1619299153
Title
Owner
Phone
(551) 998-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP414107L PA Primary

Addresses

Primary practice location

218 S Main St
Sellersville, PA 18960-2529

Mailing address

218 S Main St
Sellersville, PA 18960-2529
Phone (215) 257-9077

Other identifiers 2

IdentifierTypeStateIssuer
103609542MedicaidPA
2086660OtherPK

Other names 1

  • SELLERSVILLE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20110706000458 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3870707706 Practice locations: Sellersville, PA
O20200206002160 PA DME Supplier - Pharmacy 3971939166 Practice locations: Sellersville, PA
O20200512000065 PA Part B Supplier - Mass Immunization (Roster Biller Only) 3971939166 Practice locations: Sellersville, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2268850Sellersville Pharmacy218 S Main St, Sellersville, PA 18960Certificate of waiverSep 18, 2026

National Provider Directory

National Provider Directory

Locations

218 S Main St
#21
Sellersville, PA 18960

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1902811508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 S MAIN ST",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189602529",
            "telephone_number": "215-257-9077",
            "fax_number": "215-453-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S MAIN ST",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189602529",
            "telephone_number": "215-257-9077",
            "fax_number": "215-453-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRAJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JIGNESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "551-998-5200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP414107L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103609542",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2086660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SELLERSVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SELLERSVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sellersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.