Healthcare Provider Details

I. General information

NPI: 1467592816
Provider Name (Legal Business Name): NELL'S, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PRIMROSE LN
EAST BERLIN PA
17316-8505
US

IV. Provider business mailing address

30 PRIMROSE LN
EAST BERLIN PA
17316-8505
US

V. Phone/Fax

Practice location:
  • Phone: 717-259-6598
  • Fax: 717-259-5439
Mailing address:
  • Phone: 717-259-6598
  • Fax: 717-259-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP415789L
License Number StatePA

VIII. Authorized Official

Name: STANLEY FALENSKI
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 717-259-6598