Provider Demographics
NPI:1811567779
Name:NOVUS PHARMACY SERVICES
Entity Type:Organization
Organization Name:NOVUS PHARMACY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-867-5365
Mailing Address - Street 1:1565 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-4744
Mailing Address - Country:US
Mailing Address - Phone:610-704-1599
Mailing Address - Fax:
Practice Address - Street 1:1565 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-4744
Practice Address - Country:US
Practice Address - Phone:610-867-5365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVUS ADULT CARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1038298400001Medicaid