Provider Demographics
NPI:1376677088
Name:NEFF DRUGS II LLC
Entity Type:Organization
Organization Name:NEFF DRUGS II LLC
Other - Org Name:SUN RAY DRUGS 60TH ST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANG
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-425-5800
Mailing Address - Street 1:25 S 60TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-3003
Mailing Address - Country:US
Mailing Address - Phone:215-474-4550
Mailing Address - Fax:215-474-4551
Practice Address - Street 1:25 S 60TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3003
Practice Address - Country:US
Practice Address - Phone:215-474-4550
Practice Address - Fax:215-474-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4816963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018809890001Medicaid
2081782OtherPK