Provider Demographics
NPI:1699835942
Name:MILAN PHARMACY INC
Entity Type:Organization
Organization Name:MILAN PHARMACY INC
Other - Org Name:KING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:215-226-2000
Mailing Address - Street 1:2100 W CAMBRIA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-2632
Mailing Address - Country:US
Mailing Address - Phone:215-226-2000
Mailing Address - Fax:215-226-4896
Practice Address - Street 1:2100 W CAMBRIA ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-2632
Practice Address - Country:US
Practice Address - Phone:215-226-2000
Practice Address - Fax:215-226-4896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP-415282-L332B00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3972987OtherNABP
PA0016384080001Medicaid
3972987OtherNABP