Medical Shoppe LTD

Primary specialty

PharmacyTaxonomy code 333600000X

License

PP414702L Issued in PA

Legal business name

MEDICAL SHOPPE LTD

Practice address

1101 Main St
Honesdale, PA 18431-1907

Phone

(570) 253-7770

Fax

(570) 251-7809

NPI assigned

Jul 19, 2005

Organization subpart

No

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

Authorized official

Name

Judith A Stephens, RN

Title

President

Phone

(570) 253-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stephens Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Medical Shoppe LTD

  • Durable Medical Equipment & Medical Supplies
  • Honesdale, PA
  • NPI 1578562708

  5294873857

  Same PAC ID

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1982603189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MAIN ST.",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "18431",
            "telephone_number": "570-253-7770",
            "fax_number": "570-251-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MAIN ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311907",
            "telephone_number": "570-253-7770",
            "fax_number": "570-251-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SHOPPE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-253-7700",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP414702L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007436710003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephens Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sean Kevin McVeigh, MD
• Kelli Mead, DPT
• Rebecca Anne Mead
• Medical Shoppe LTD
• Medical Shoppe LTD
• Ann M Mekilo, MS, PA-C
• Gianna Catherine Memo, DPT
• Rebecca Metzelaar
• Michael C. Rogers, DDS, PC
• Carl John Milks, M.D.08/

• Pharmacy in Honesdale, PA
• Providers in Honesdale, PA by specialty
• Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.