Provider Demographics
NPI:1538284732
Name:SYNERGY PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:SYNERGY PHARMACY SERVICES LLC
Other - Org Name:SYNERGY PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:610-539-5093
Mailing Address - Street 1:2500 BLVD OF THE GENERAL
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403
Mailing Address - Country:US
Mailing Address - Phone:610-539-5093
Mailing Address - Fax:610-539-5294
Practice Address - Street 1:2500 BLVD OF THE GENERAL
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403
Practice Address - Country:US
Practice Address - Phone:610-539-5093
Practice Address - Fax:610-539-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
PAPP4817023336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7P1702Medicaid
NY03055465Medicaid
DC051848400Medicaid
CT1538284732Medicaid
DE1538284732Medicaid
NJ0276049Medicaid
PA101859813001Medicaid
VA1538284732Medicaid
OH0059680Medicaid
WA2017862Medicaid
2081785OtherPK
MD418509900Medicaid