Healthcare Provider Details

I. General information

NPI: 1437064235
Provider Name (Legal Business Name): CHEWY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 RESEARCH DR
PITTSTON PA
18640-6141
US

IV. Provider business mailing address

11403 BLUEGRASS PKWY STE 780
LOUISVILLE KY
40299-2388
US

V. Phone/Fax

Practice location:
  • Phone: 570-569-4673
  • Fax: 866-253-0274
Mailing address:
  • Phone: 502-541-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. MAGAN WAGNER
Title or Position: LICENSING & ACCREDITATION MANAGER
Credential:
Phone: 502-541-7710