Provider Demographics
NPI:1851143416
Name:ACADEMY PHARMACY LLC
Entity Type:Organization
Organization Name:ACADEMY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER LLC
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:RPH
Authorized Official - Phone:215-632-2121
Mailing Address - Street 1:10101 ACADEMY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1120
Mailing Address - Country:US
Mailing Address - Phone:215-632-2121
Mailing Address - Fax:215-632-6107
Practice Address - Street 1:10101 ACADEMY RD STE 105
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1120
Practice Address - Country:US
Practice Address - Phone:215-632-2121
Practice Address - Fax:215-632-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy