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General NPI Number Information
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NPI Number | 1407389943
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Entity Type | Organization
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Legal Business Name | PENNYMED PHARMACY LLC
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 7956 DUNGAN RD
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2737
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Country | US
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Telephone | 215-437-9215
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Fax | 215-904-8654
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | LEVITTOWN
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State | PA
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Zip | 19058-0429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | KAUSHAL PATEL
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Credential |
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Telephone | 215-915-6989
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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 | PP482716
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License Number State | PA
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