Main Street Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410712L Issued in PA

Legal business name

MAIN STREET DRUG STORE INC

Doing business as

Everett Pharmacy

Practice address

108 E Main St
Everett, PA 15537-1258

Phone

(814) 652-5532

Fax

(814) 652-2927

NPI assigned

Feb 13, 2009

Organization subpart

No

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

Authorized official

Name

Karen Iseminger

Title

Authorized Official

Phone

(814) 652-5532

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Everett Pharmacy Doing business as

Practitioners 1

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

• Daniel Norman Iseminger, RPH

  • Pharmacist
  • Hyndman, PA
  • NPI 1104372762
  NPD

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1922247097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E MAIN ST",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155371258",
            "telephone_number": "814-652-5532",
            "fax_number": "814-652-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E MAIN ST",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155371258",
            "telephone_number": "814-652-5532",
            "fax_number": "814-652-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "ISEMINGER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "814-652-5532"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410712L",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022770360001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3991761",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559319",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everett Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelah Layton, CPT
• Eric Joseph Lieb
• Melanie Dawn Loop, PTA
• Scott M Love, DPT
• Lowers Pharmacy Inc
• Stanley Samuel Manges, DC
• Mark S. Rakoczy, O.D
• Ashley L. McCahan, DPT
• Stephen W McCahan, PHARMD
• Judy Elinor McCann, M.S.

• Community/Retail Pharmacy in Everett, PA
• Providers in Everett, 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 Dec 19, 2012; 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.