OLD ROSWELL HOLDINGS LLC NPI 1619240025

NPI Information

  • NPI: 1619240025
  • Provider Name: OLD ROSWELL HOLDINGS LLC
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • :
  • Address: 3913 HARTZDALE DR
    SUITE 1306
    CAMP HILL, PA
    ZIP 17011
  • Phone: (717) 766-6191

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NPI Details

OLD ROSWELL HOLDINGS LLC is a long term care pharmacy pharmacy in Camp Hill, PA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. OLD ROSWELL HOLDINGS LLC NPI is 1619240025. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

3913 HARTZDALE DR
SUITE 1306
CAMP HILL, PA
ZIP 17011-845
Phone: (717) 766-6191
Fax: (717) 691-1052

The provider's authorized official is Tracy Eden .
The authorized official title is Manager and has the following contact phone number (404) 459-8005.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 2/15/2012 and was last updated on 4/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336L0003XPharmacyLong Term Care PharmacyNo
33336L0003XPharmacyLong Term Care PharmacyPP481575PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10018224450018MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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