Provider Demographics
NPI:1033348859
Name:A & M PHARMACY INC
Entity Type:Organization
Organization Name:A & M PHARMACY INC
Other - Org Name:ALLTOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:917-750-7672
Mailing Address - Street 1:1137 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7609
Mailing Address - Country:US
Mailing Address - Phone:215-354-9440
Mailing Address - Fax:215-354-9118
Practice Address - Street 1:1137 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7609
Practice Address - Country:US
Practice Address - Phone:215-354-9440
Practice Address - Fax:215-354-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481923333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023781550001Medicaid
PA6342140001Medicare NSC