Provider Demographics
NPI:1972191948
Name:ZENMAX LLC
Entity Type:Organization
Organization Name:ZENMAX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PADMANABHUNI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:484-658-3339
Mailing Address - Street 1:2304 LYDIA HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1065
Mailing Address - Country:US
Mailing Address - Phone:484-658-3339
Mailing Address - Fax:866-421-4089
Practice Address - Street 1:2304 LYDIA HOLLOW DR
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1065
Practice Address - Country:US
Practice Address - Phone:484-658-3339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site