Provider Demographics
NPI:1336554575
Name:UNIVERSAL PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:UNIVERSAL PHARMACY SERVICES, LLC
Other - Org Name:SYNERGY RX EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NYARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-323-1687
Mailing Address - Street 1:315 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-1034
Mailing Address - Country:US
Mailing Address - Phone:302-323-1687
Mailing Address - Fax:302-323-1689
Practice Address - Street 1:601 NEW CASTLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5821
Practice Address - Country:US
Practice Address - Phone:302-323-1687
Practice Address - Fax:302-323-1689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336M0003X, 3336S0011X
DEA3-00009703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145479OtherPK