Provider Demographics
NPI:1578663308
Name:NELL'S, INC
Entity Type:Organization
Organization Name:NELL'S, INC
Other - Org Name:SHURFINE PHARMACY- SPRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUSNAK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-741-5973
Mailing Address - Street 1:2720 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-9701
Mailing Address - Country:US
Mailing Address - Phone:717-741-5973
Mailing Address - Fax:717-747-5461
Practice Address - Street 1:2720 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-9701
Practice Address - Country:US
Practice Address - Phone:717-741-5973
Practice Address - Fax:717-747-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415170L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100778158-0012Medicaid
PA1578663308OtherNPI
3971721OtherNABP
3971721OtherNABP
BS4907222OtherDEA