Provider Demographics
NPI:1801155957
Name:MARKET PHARMACY INC
Entity type:Organization
Organization Name:MARKET PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:KILIMNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-317-5489
Mailing Address - Street 1:3901 MARKET ST
Mailing Address - Street 2:#3
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3133
Mailing Address - Country:US
Mailing Address - Phone:215-387-3900
Mailing Address - Fax:
Practice Address - Street 1:3901 MARKET ST # 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3133
Practice Address - Country:US
Practice Address - Phone:215-387-3900
Practice Address - Fax:215-387-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4822493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027075300001Medicaid
3997345OtherNCPDP PROVIDER IDENTIFICATION NUMBER