Provider Demographics
NPI:1952628539
Name:NEFF DRUGS 28 LLC
Entity Type:Organization
Organization Name:NEFF DRUGS 28 LLC
Other - Org Name:YORK ST. PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-776-8964
Mailing Address - Street 1:2334 E YORK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3029
Mailing Address - Country:US
Mailing Address - Phone:215-427-1200
Mailing Address - Fax:215-427-1207
Practice Address - Street 1:2334 E YORK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3029
Practice Address - Country:US
Practice Address - Phone:215-427-1200
Practice Address - Fax:215-427-1207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4820583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2126628OtherPK
PA1032173910001Medicaid