MEDICARE: NEFF DRUGS 30 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy
2	333600000X	Pharmacy
3	3336S0011X	Specialty Pharmacy	PP482659	PA

General Provider Information

NPI Number	:	1477904449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEFF DRUGS 30 LLC

Provider Business Mailing Address
First Line	:	142 S 52ND ST
Second Line	:	SUITE 201
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-3409
Country	:	US
Telephone Number	:	215-471-4000
Fax Number	:	215-471-4001

Provider Business Practice Location Address
First Line	:	142 S 52ND ST
Second Line	:	SUITE 201
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-3409
Country	:	US
Telephone Number	:	215-471-4000
Fax Number	:	215-471-4001

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	ELISSA DEVENNY
Credential	:	PHARMD
Telephone Number	:	215-471-4000

Provider Enumeration Date	:	06/30/2016
Last Update Date	:	05/21/2024

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