Provider Demographics
NPI:1336325265
Name:TRANSITION PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:TRANSITION PHARMACY SERVICES, LLC
Other - Org Name:TRANSITION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-639-6162
Mailing Address - Street 1:2546 METROPOLITAN DR
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6738
Mailing Address - Country:US
Mailing Address - Phone:215-639-6162
Mailing Address - Fax:215-639-6209
Practice Address - Street 1:2540 METROPOLITAN DR STE 2546
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6738
Practice Address - Country:US
Practice Address - Phone:215-639-6162
Practice Address - Fax:215-639-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481773333600000X
3336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020919290001Medicaid
IN201072320AMedicaid
2082375OtherPK
IL2054258131905301Medicaid
PA0311421Medicaid
DE1336325265Medicaid
PA1020919290001Medicaid