Healthcare Provider Details
I. General information
NPI: 1154246957
Provider Name (Legal Business Name): PENN RX PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
95 FERRY ST
NEWARK NJ
07105-1816
US
IV. Provider business mailing address
95 FERRY ST
NEWARK NJ
07105-1816
US
V. Phone/Fax
- Phone: 973-732-9181
- Fax: 973-732-9180
- Phone: 973-732-9181
- Fax: 973-732-9180
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMR
ELABBASY
Title or Position: PRESIDENT
Credential:
Phone: 973-732-9181