Provider Demographics
NPI:1336259647
Name:NELLS, INC.
Entity Type:Organization
Organization Name:NELLS, INC.
Other - Org Name:SHURFINE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-678-6610
Mailing Address - Street 1:4724 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9672
Mailing Address - Country:US
Mailing Address - Phone:610-678-6610
Mailing Address - Fax:610-678-7710
Practice Address - Street 1:4724 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-9672
Practice Address - Country:US
Practice Address - Phone:610-678-6610
Practice Address - Fax:610-678-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415482L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP415482LOtherSTATE LICENSE
PA1007781580001OtherPROMISE ID
PA0397540OtherPACE
PA01726823Medicaid
PA3975402OtherNCPDP
PA3975402OtherNCPDP
PA4158280001Medicare NSC