Provider Demographics
NPI:1619974268
Name:MURRAY-OVERHILL PHARMACY INC.
Entity Type:Organization
Organization Name:MURRAY-OVERHILL PHARMACY INC.
Other - Org Name:MURRAY-OVERHILL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. OPRNS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:BRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-566-2345
Mailing Address - Street 1:32 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3319
Mailing Address - Country:US
Mailing Address - Phone:610-566-2345
Mailing Address - Fax:610-565-0837
Practice Address - Street 1:32 W STATE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3319
Practice Address - Country:US
Practice Address - Phone:610-566-2345
Practice Address - Fax:610-565-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411657L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3963849OtherNABP
PAPP411657LOtherPA STATE BOARD OF PHARM.
PA001265637Medicaid
PA001265637Medicaid
PA001265637Medicaid