Provider Demographics
NPI:1578952156
Name:APPRAISED LLC
Entity Type:Organization
Organization Name:APPRAISED LLC
Other - Org Name:SHOP AND CARRY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JITTU
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-779-9378
Mailing Address - Street 1:1301 LINDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2747
Mailing Address - Country:US
Mailing Address - Phone:267-297-5030
Mailing Address - Fax:267-297-5783
Practice Address - Street 1:1301 LINDLEY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2747
Practice Address - Country:US
Practice Address - Phone:267-297-5030
Practice Address - Fax:267-297-5783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4825223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149727OtherPK
PA1030004280001Medicaid
PA7457970001Medicare NSC