Provider Demographics
NPI:1508999525
Name:PROFESSIONAL PHARMACY AND CONVALESCENT PRODUCTS. LTD.
Entity Type:Organization
Organization Name:PROFESSIONAL PHARMACY AND CONVALESCENT PRODUCTS. LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:YANOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:610-323-5411
Mailing Address - Street 1:911 N CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3958
Mailing Address - Country:US
Mailing Address - Phone:610-323-5411
Mailing Address - Fax:610-327-3243
Practice Address - Street 1:911 N CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3958
Practice Address - Country:US
Practice Address - Phone:610-323-5411
Practice Address - Fax:610-327-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA310571Medicare ID - Type Unspecified