Provider Demographics
NPI:1700856010
Name:NEFF-WAYNE ENTERPRISE,INC.
Entity Type:Organization
Organization Name:NEFF-WAYNE ENTERPRISE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:RALSTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:610-688-5321
Mailing Address - Street 1:249 E SWEDESFORD RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1462
Mailing Address - Country:US
Mailing Address - Phone:610-688-5321
Mailing Address - Fax:610-688-8973
Practice Address - Street 1:249 E SWEDESFORD RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1462
Practice Address - Country:US
Practice Address - Phone:610-688-5321
Practice Address - Fax:610-688-8973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410842L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011159070001Medicaid
PA3954167OtherNCPDP
PAPP410842LOtherSTATE PHARMACY PERMIT
PAPP410842LOtherSTATE PHARMACY PERMIT
PA3954167OtherNCPDP
PAPP410842LOtherSTATE PHARMACY PERMIT