Independent RX Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482369 Issued in PA

Legal business name

INDEPENDENT RX INCORPORATED

Doing business as

Centennial Pharmacy-Queen Village

Practice address

843 S 2ND St Ste 2
Philadelphia, PA 19147-3445

Phone

(267) 324-5347

Fax

(267) 324-5418

NPI assigned

May 16, 2013

Last updated

Nov 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph DymowskiNPI 1659735868

Title

President/Owner

Phone

(267) 324-5347

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Centennial Pharmacy-Queen Village Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Dymowski

  • Pharmacist
  • Philadelphia, PA
  • NPI 1659735868
  NPD (past) Authorized official
• Matthew Phillip Lyle, PHARMD

  • Pharmacist
  • Philadelphia, PA
  • NPI 1306333141
  NPD (past)

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1992141030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 LEFEVRE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191372044",
            "telephone_number": "215-535-4111",
            "fax_number": "215-535-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 S 2ND ST STE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191473445",
            "telephone_number": "267-324-5347",
            "fax_number": "267-324-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT RX INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "DYMOWSKI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "267-324-5347"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102466113002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Pharmacy-Queen Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Independent Pharmacies Incorporated (Centennial pharmacy southphilly)
• Independent Physicians Medical Center, LLC
• Independent Physicians Medical Center, LLC
• Independent Quality Services Inc
• Independent RX Incorporated (Centennial Pharmacy-Bridesburg)
• Jonathan Howard Indik, MD
• Indlovu, LLC (Ellie Mental Health Philadelphia)
• Andrew C. Indriso, D.C.
• Indulge Nursing Care Agency
• Vikranth Reddy Induru, MD

• 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 Nov 23, 2015; 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.