Healthcare Provider Details

I. General information

NPI: 1699052167
Provider Name (Legal Business Name): DOYLESTOWN DRUGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W STATE ST
DOYLESTOWN PA
18901-3514
US

IV. Provider business mailing address

PO BOX 428
LEVITTOWN PA
19058-0428
US

V. Phone/Fax

Practice location:
  • Phone: 215-348-3344
  • Fax: 215-348-1504
Mailing address:
  • Phone: 215-915-6989
  • Fax: 888-979-2677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP482207
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1028469450001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier2141635
Identifier TypeOTHER
Identifier State
Identifier IssuerPK

VIII. Authorized Official

Name: KAUSHAL PATEL
Title or Position: PRESIDENT
Credential:
Phone: 917-667-6989