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General NPI Number Information
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NPI Number | 1578519120
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Entity Type | Organization
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Legal Business Name | ACME MARKETS INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 550 W TRENTON AVE
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City | MORRISVILLE
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State | PA
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Zip | 19067-3593
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Country | US
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Telephone | 215-428-4683
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Fax | 215-428-2460
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Provider Business Mailing Address
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Address Line | 3030 CULLERTON ST
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City | FRANKLIN PARK
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State | IL
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Zip | 60131-2205
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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 | THIRD PARTY MANAGER
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Name | DEMOND HAWKINS
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Credential |
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Telephone | 208-395-3905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP415082L
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License Number State | PA
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