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NPI Code Detail

MEDICARE: ACME MARKETS INC

MEDICARE: ACME MARKETS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail PharmacyPP481337PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12086788OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073569570
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACME MARKETS INC
Provider Business Mailing Address
First Line : 250 E PARKCENTER BLVD
Second Line : MAILSTOP SEC2-B
City : BOISE
State : ID
Zip : 83706-3940
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7010 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-1826
Country : US
Telephone Number : 215-247-4995
Fax Number : 215-247-5488
Authorized Official
Title or Position : ASSISTANT MANAGER, ENROLLMENTS
Name : TIFFANY ELIOPULOS
Credential :
Telephone Number : 208-395-3906
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/10/2018

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Directions to “ACME MARKETS INC ” Practice Location

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