Individual provider Active NPI

Cristina Penetar, RPH

  • Pharmacist
  • Sayre, PA
National Provider Identifier
1962828939
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP448309 Issued in PA
Practice address
2968 Elmira St
Sayre, PA 18840-2600
Phone
(570) 888-7516
NPI assigned
Mar 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP448309 PA Primary
Pharmacist 183500000X 0202212630 VA

Addresses

Primary practice location

2968 Elmira St
Sayre, PA 18840-2600

Mailing address

2968 Elmira St
Sayre, PA 18840-2600
Phone (570) 888-7516

Other identifiers 2

IdentifierTypeStateIssuer
RP448309OtherPAPENNSYLVANIA BOARD OF PHARMACY
0202212630OtherVAVIRGINIA BOARD OF PHARMACY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP448309PAMDPharmacist
0202212630VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Pennsylvania LLC Past Accepting new patients
Rite Aid of Pennsylvania LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1962828939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 ELMIRA ST",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188402600",
            "telephone_number": "570-888-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 ELMIRA ST",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188402600",
            "telephone_number": "570-888-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENETAR",
        "first_name": "CRISTINA",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP448309",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202212630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA BOARD OF PHARMACY",
            "identifier": "RP448309",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF PHARMACY",
            "identifier": "0202212630",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.