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General NPI Number Information
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NPI Number | 1942221916
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Entity Type | Organization
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Legal Business Name | CLEMENS MARKET INC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 616 E MAIN ST HILLCREST SHOPPING CENTER
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City | LANSDALE
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State | PA
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Zip | 19446-2964
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Country | US
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Telephone | 215-855-0734
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Fax | 215-855-8350
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Provider Business Mailing Address
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Address Line | 616 E MAIN ST HILLCREST SHOPPING CENTER
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City | LANSDALE
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State | PA
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Zip | 19446-2964
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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 | DIR OF PHARMACY
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Name | RONALD SHAPIRO
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Credential |
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Telephone | 215-361-9000
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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 | PP481110
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License Number State | PA
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