Active NPI
Shady Maple Pharmacy
- Community/Retail Pharmacy
- East Earl, PA
National Provider Identifier
1932145950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PP481512
- Legal business name
- SHADY MAPLE PHARMACY
- Doing business as
- SHADY MAPLE PHARMACY
- Practice address
- 1324 Main St
East Earl, PA 17519-9508 - Phone
- (717) 355-9424
- Fax
- (717) 351-0253
- NPI assigned
- Jun 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark S East
- Title
- Pharmacist in Charge
- Phone
- (717) 355-9424
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PP481512 | PA | Primary |
Addresses
Primary practice location
1324 Main St
East Earl, PA 17519-9508
Mailing address
PO Box 137
East Earl, PA 17519-0137
Phone (717) 355-9424
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2087490 | Other | PK | |
| 1014656950001 | Medicaid | PA |
Other names 1
- SHADY MAPLE PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Shady Maple Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- New Holland, PA
- NPI 1376987313
Locations
1324 Main St
East Earl, PA 17519
Phone (717) 355-9424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1752192000000",
"number": "1932145950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 137",
"city": "EAST EARL",
"state": "PA",
"postal_code": "175190137",
"telephone_number": "717-355-9424",
"fax_number": "717-351-0253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 MAIN ST",
"city": "EAST EARL",
"state": "PA",
"postal_code": "175199508",
"telephone_number": "717-355-9424",
"fax_number": "717-351-0253"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHADY MAPLE PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-20",
"last_updated": "2025-07-11",
"certification_date": "2025-07-11",
"status": "A",
"authorized_official_last_name": "EAST",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PHARMACIST IN CHARGE",
"authorized_official_telephone_number": "717-355-9424"
},
"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": "PP481512",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2087490",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1014656950001",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SHADY MAPLE PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in East Earl, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.