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General NPI Number Information
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NPI Number | 1134189749
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Entity Type | Organization
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Legal Business Name | NISENHOLTZ PHARMACY INC
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 7624 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3623
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Country | US
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Telephone | 215-342-7676
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Fax | 215-342-1593
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Provider Business Mailing Address
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Address Line | 7624 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3623
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Country | US
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Telephone | 215-342-7676
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Fax | 215-342-1593
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Authorized Official
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Title or Position | OWNER/PHARMACY MANAGER
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Name | MR. JAMES V REGINELLI
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Credential | R.PH.
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Telephone | 215-342-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP411697L
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License Number State | PA
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