Provider Demographics
NPI:1275675563
Name:SUPER HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:SUPER HEALTH ASSOCIATES
Other - Org Name:CORNERSTONE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKET
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-706-2001
Mailing Address - Street 1:41 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-3201
Mailing Address - Country:US
Mailing Address - Phone:215-706-2001
Mailing Address - Fax:
Practice Address - Street 1:41 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-3201
Practice Address - Country:US
Practice Address - Phone:215-706-2001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4812233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy