Provider Demographics
NPI:1407110141
Name:NEFF DRUGS 20 LLC
Entity Type:Organization
Organization Name:NEFF DRUGS 20 LLC
Other - Org Name:SUNRAY DRUGS C STREET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-630-4650
Mailing Address - Street 1:424 E ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-2327
Mailing Address - Country:US
Mailing Address - Phone:215-423-8500
Mailing Address - Fax:215-423-8400
Practice Address - Street 1:424 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2327
Practice Address - Country:US
Practice Address - Phone:215-423-8500
Practice Address - Fax:215-423-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4823213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135819OtherPK
PA1027843970001Medicaid