Healthcare Provider Details

I. General information

NPI: 1114354735
Provider Name (Legal Business Name): MCNEILL FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SCHEIVERT AVE
ASTON PA
19014-2762
US

IV. Provider business mailing address

10 SCHEIVERT AVE
ASTON PA
19014-2762
US

V. Phone/Fax

Practice location:
  • Phone: 610-494-1445
  • Fax: 610-494-7697
Mailing address:
  • Phone: 610-494-1445
  • Fax: 610-494-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP410090L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARIA MCNEILL
Title or Position: CO-OWNER
Credential:
Phone: 610-564-3082