Active NPI
Gerald Odonnell III, PHARMD
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1972107993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP453648
- Practice address
- 8525 Frankford Ave
Philadelphia, PA 19136-2444 - Phone
- (215) 331-9762
- NPI assigned
- Nov 30, 2020
- Last updated
- Nov 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP453648 | PA | Primary |
Addresses
Primary practice location
8525 Frankford Ave
Philadelphia, PA 19136-2444
Mailing address
2548 E Ann St
Phila, PA 19134-4949
Phone (267) 319-5457
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP453648 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy LLC | Past | Accepting new patients | |
| Pennsylvania CVS Pharmacy, L.L.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1972107993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2548 E ANN ST",
"city": "PHILA",
"state": "PA",
"postal_code": "191344949",
"telephone_number": "267-319-5457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8525 FRANKFORD AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191362444",
"telephone_number": "215-331-9762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODONNELL",
"first_name": "GERALD",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP453648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.