1437160009 NPI number — CONTRACT PHARMACY SERVICES INC

Table of content: (NPI 1437160009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437160009 NPI number — CONTRACT PHARMACY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONTRACT PHARMACY SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CPS ABRAMSON CENTER PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437160009
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 TITUS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARRINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18976-2424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-333-5012
Provider Business Mailing Address Fax Number:
800-631-1716

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1425 HORSHAM RD
Provider Second Line Business Practice Location Address:
2ND FL
Provider Business Practice Location Address City Name:
NORTH WALES
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19454-1320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-371-1380
Provider Business Practice Location Address Fax Number:
215-371-3086
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHAFER
Authorized Official First Name:
WAYNE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
267-478-8900

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: PP481617 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100750649002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2087993 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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