Provider Demographics
NPI:1467894600
Name:US 1 PHARMACY
Entity Type:Organization
Organization Name:US 1 PHARMACY
Other - Org Name:US1 PHARMACEUTICALS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-620-9398
Mailing Address - Street 1:1254 E LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3005
Mailing Address - Country:US
Mailing Address - Phone:215-750-0111
Mailing Address - Fax:215-750-0888
Practice Address - Street 1:1254 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-3005
Practice Address - Country:US
Practice Address - Phone:215-750-0111
Practice Address - Fax:215-750-0888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP482386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102852826 0001Medicaid