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Penn Traffic Co

Community/Retail Pharmacy in Du Bois, PA · enumerated 2006 · authorized official Daniel Mahoney, Svp/General Counsel.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1629099940

Verified

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Registry record

Entity type Organization (Type 2)
Legal business name Penn Traffic Co
Other name <Unavail>
Practice address 100 N Main St, Du Bois, PA, 15801
Fax (814) 375-9704
Enumeration date Jul 21, 2006
Last updated in NPPES Feb 10, 2010

Taxonomy & classification

333600000X Pharmacy Suppliers · License PP412682L (PA) Secondary
3336C0003X Community/Retail Pharmacy Suppliers Primary

Authorized official

Name Daniel Mahoney
Title Svp/General Counsel

Other identifiers

Identifier Type State Issuer
3961035 Other - NCPDP
3961035 Other - OTHER ID NUMBER-COMMERCIAL NUMBER
01215180 Medicaid PA -
1007783900001 Other - PA PROMISE- MEDICAID

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Penn Traffic Co?
Penn Traffic Co is registered in NPPES as a Community/Retail Pharmacy (its primary provider taxonomy).

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-02-10.