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General NPI Number Information
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NPI Number | 1396173662
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Entity Type | Organization
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Legal Business Name | DREAM RX, LLC
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Dates
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Enumeration Date | 10/24/2013
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 4117 MAIN ST
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City | WHITEHALL
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State | PA
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Zip | 18052-1607
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Country | US
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Telephone | 610-440-6337
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Fax |
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Provider Business Mailing Address
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Address Line | 4117 MAIN ST
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City | WHITEHALL
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State | PA
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Zip | 18052-1607
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Country | US
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Telephone | 610-440-6337
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | RIKIN PATEL
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Credential | PHARM.D.
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Telephone | 610-440-6337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482428
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License Number State | PA
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