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NPI Code Detail

MEDICARE: ADVANTAGE PHARMACY SOLUTIONS LLC

MEDICARE: ADVANTAGE PHARMACY SOLUTIONS LLC
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
13336C0003XCommunity/Retail Pharmacy
23336L0003XLong Term Care Pharmacy28RS00672300NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23144336OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336154954
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANTAGE PHARMACY SOLUTIONS LLC
Provider Business Mailing Address
First Line : 1417 BRACE RD
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08034-3524
Country : US
Telephone Number : 856-796-9500
Fax Number : 856-795-7771
Provider Business Practice Location Address
First Line : 1417 BRACE RD
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08034-3524
Country : US
Telephone Number : 856-796-9500
Fax Number : 856-795-7771
Authorized Official
Title or Position : MANAGING MEMBER
Name : AVERY EISENRIECH
Credential :
Telephone Number : 201-216-9502
Provider Enumeration Date : 07/30/2006
Last Update Date : 09/27/2010

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Directions to “ADVANTAGE PHARMACY SOLUTIONS LLC ” Practice Location

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