Provider Demographics
NPI:1811710759
Name:PKP HEALTH LLC
Entity type:Organization
Organization Name:PKP HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:610-482-0060
Mailing Address - Street 1:420 SCHUYLKILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-5219
Mailing Address - Country:US
Mailing Address - Phone:610-482-0060
Mailing Address - Fax:610-482-0061
Practice Address - Street 1:420 SCHUYLKILL RD STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-5219
Practice Address - Country:US
Practice Address - Phone:610-482-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104417913-0001Medicaid