Provider Demographics
NPI:1124410360
Name:NELLS FAMILY MARKET OF SPRY LLC
Entity Type:Organization
Organization Name:NELLS FAMILY MARKET OF SPRY LLC
Other - Org Name:NELL'S PHARMACY SPRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNGRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-547-9605
Mailing Address - Street 1:NELL'S ACCOUNTING
Mailing Address - Street 2:600 ARSENAL ROAD
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402
Mailing Address - Country:US
Mailing Address - Phone:717-854-5800
Mailing Address - Fax:914-407-1649
Practice Address - Street 1:2720 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-9701
Practice Address - Country:US
Practice Address - Phone:717-741-5973
Practice Address - Fax:717-747-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP415170L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150480OtherPK