Suburban Bustleton Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP412433L Issued in PA

Legal business name

SUBURBAN BUSTLETON PHARMACY INC.

Doing business as

Suburban Pharmacy

Practice address

10875 Bustleton Avenue
Philadelphia, PA 19116-3301

Phone

(215) 673-0994

Fax

(215) 969-6176

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jane Dzierza

Title

Owner

Phone

(215) 673-0994

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Suburban Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Lenny Fox

  • Pharmacist
  • Philadelphia, PA
  • NPI 1629601943
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1962560565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163301",
            "telephone_number": "215-673-0994",
            "fax_number": "215-969-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 BUSTLETON AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163301",
            "telephone_number": "215-673-0994",
            "fax_number": "215-969-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN BUSTLETON PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "DZIERZA",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-673-0994",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412433L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014348470001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Suburban Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Divya Subramanian Khurana, MD
• Apoorva Subramanian, MD
• Pearl Subramanian
• Srinivas Subramanian, MD
• Substantial Home Care LLC
• Suburban Rehabilitation Associates, LLC
• Michael J Suchar, DDS
• Monica L Sucharski, DNP
• Nicholas Thomas Sucic Jr., PHARMD
• Cereseia Sucki

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, 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 Jan 21, 2026; 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.