Provider Demographics
NPI:1578641585
Name:PHOEBE SERVICES INC
Entity Type:Organization
Organization Name:PHOEBE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RICHART
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-794-5380
Mailing Address - Street 1:6520 STONEGATE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9297
Mailing Address - Country:US
Mailing Address - Phone:610-794-5380
Mailing Address - Fax:610-794-5415
Practice Address - Street 1:6520 STONEGATE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9297
Practice Address - Country:US
Practice Address - Phone:610-794-5380
Practice Address - Fax:610-794-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415071L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017045210001Medicaid