Provider Demographics
NPI:1760778740
Name:A PLUS PHARMACY INC
Entity Type:Organization
Organization Name:A PLUS PHARMACY INC
Other - Org Name:A PLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASVIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-731-6163
Mailing Address - Street 1:13023 BUSTLETON AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1672
Mailing Address - Country:US
Mailing Address - Phone:267-731-6163
Mailing Address - Fax:267-731-6167
Practice Address - Street 1:13023 BUSTLETON AVE STE 1C
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1672
Practice Address - Country:US
Practice Address - Phone:267-731-6163
Practice Address - Fax:267-731-6167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4821833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026468000001Medicaid
2132429OtherPK