Pennsport Mall Pharmacy
LBN: Pennsport Mall Pharmacy Llc
Pennsport Mall Pharmacy is an health care organization with primary practice located at 237 Mcclellan St , Philadelphia PA 19148-1954. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Pennsport Mall Pharmacy Llc can be contacted via phone (267) 639-4657, or through Cuffari, Gino via phone (267) 340-7534.
Contact Information
Primary practice address
237 Mcclellan St
Philadelphia PA 19148-1954
Phone: (267) 639-4657
Fax: (267) 687-2583
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PP482611 | Pennsylvania |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1366817991 |
|---|---|
| LBN Legal business name | Pennsport Mall Pharmacy Llc |
| DBA Doing business as | Pennsport Mall Pharmacy |
| Authorized official | Cuffari, Gino |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 8th, 2015 |
| Last updated | Jul 19th, 2018 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366817991 | NPPES |
| Pennsylvania | MEDICAID | 1030762100001 | |
| Pennsylvania | Other | 2155869 |
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