Provider Demographics
NPI:1770503260
Name:BECHTEL'S PHARMACY, INC
Entity Type:Organization
Organization Name:BECHTEL'S PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BECHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-767-9020
Mailing Address - Street 1:4423 LEHIGH DR
Mailing Address - Street 2:
Mailing Address - City:WALNUTPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18088-9513
Mailing Address - Country:US
Mailing Address - Phone:610-767-9020
Mailing Address - Fax:610-760-9449
Practice Address - Street 1:4423 LEHIGH DR
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-9513
Practice Address - Country:US
Practice Address - Phone:610-767-9020
Practice Address - Fax:610-760-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413870L332B00000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3952733OtherNCPDP
PA1007638610001Medicaid
0983530001Medicare NSC