Greg Derderian

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

RP438742 Issued in PA

Practice address

160 S Main St
Doylestown, PA 18901-4875

Phone

(215) 230-1960

NPI assigned

Nov 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pennsylvania CVS Pharmacy LLC

  • Pharmacy
  • Doylestown, PA
  • NPI 1992809784
  NPD (past)
• Pennsylvania CVS Pharmacy, L.L.C.

  • Pharmacy
  • West Chester, PA
  • NPI 1639063571
  NPD (past)

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": "1972108934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S MAIN ST",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189014875",
            "telephone_number": "215-230-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S MAIN ST",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189014875",
            "telephone_number": "215-230-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERDERIAN",
        "first_name": "GREG",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "PA",
            "license": "RP438742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvs",
            "affiliation": "N",
            "endpointDescription": "cvs",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "160 S Main St",
            "city": "Doylestown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189014875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Demoss, RDN
• Mark Demshick, CRNA
• Dental Excellence of Doylestown
• Karen T. Denucci, CRNP-C
• Erica Depalma, FNP-BC
• Madeline Rose Derham, PA-C
• Dermatology and Mohs Surgery Center PC
• Dermatology Partners Unified LLC
• Derrick & Harrison PC
• Bruce M Derrick, MD

• Ambulatory Care Pharmacist in Doylestown, PA
• Providers in Doylestown, PA by specialty
• Ambulatory Care Pharmacist in Pennsylvania

• 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.

Verify at the official NPI Registry.