MEDICARE: NEFF DRUGS 28 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
1	3336C0003X	Community/Retail Pharmacy	PP482058	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2126628	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952628539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEFF DRUGS 28 LLC

Provider Business Mailing Address
First Line	:	2334 E YORK ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-3029
Country	:	US
Telephone Number	:	215-427-1200
Fax Number	:	215-427-1207

Provider Business Practice Location Address
First Line	:	2334 E YORK ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-3029
Country	:	US
Telephone Number	:	215-427-1200
Fax Number	:	215-427-1207

Authorized Official
Title or Position	:	MEMBER
Name	:	JIMMY LUU
Credential	:
Telephone Number	:	215-776-8964

Provider Enumeration Date	:	04/22/2010
Last Update Date	:	11/17/2016

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