Provider Demographics
NPI:1821238981
Name:NEFF DRUGS 12 LLC
Entity Type:Organization
Organization Name:NEFF DRUGS 12 LLC
Other - Org Name:SUNRAY DRUGS 56TH AND MARKET STREETS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:TANCREDI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:856-278-1647
Mailing Address - Street 1:5537 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-3209
Mailing Address - Country:US
Mailing Address - Phone:856-278-1647
Mailing Address - Fax:215-476-9821
Practice Address - Street 1:5537 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3209
Practice Address - Country:US
Practice Address - Phone:856-278-1647
Practice Address - Fax:215-476-9821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPENDING3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy