Provider Demographics
NPI:1639498942
Name:BELLS MARKET PHARMACY CORP
Entity Type:Organization
Organization Name:BELLS MARKET PHARMACY CORP
Other - Org Name:BELLS MARKET PHARMACY CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:V
Authorized Official - Last Name:PENDRAK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-342-6016
Mailing Address - Street 1:8330 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1909
Mailing Address - Country:US
Mailing Address - Phone:215-342-6016
Mailing Address - Fax:
Practice Address - Street 1:8330 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1909
Practice Address - Country:US
Practice Address - Phone:215-342-6016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELLS MARKET PHARMACY CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-26
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4820053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP482005OtherCOMMONWEALTH OF PENNSYLVANIA