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General NPI Number Information
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NPI Number | 1609207299
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Entity Type | Organization
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Legal Business Name | MENA LLC
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 101 W LANCASTER AVE
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City | SHILLINGTON
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State | PA
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Zip | 19607-1857
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Country | US
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Telephone | 610-777-2313
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Fax | 610-777-2319
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Provider Business Mailing Address
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Address Line | 101 W LANCASTER AVE
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City | SHILLINGTON
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State | PA
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Zip | 19607-1857
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Country | US
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Telephone | 610-777-2313
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Fax | 610-777-2319
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DIPAK PATEL
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Credential |
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Telephone | 610-858-5792
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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 | PP482411
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License Number State | PA
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