Provider Demographics
NPI:1932264827
Name:CHEMRX SALERNOS LLC
Entity Type:Organization
Organization Name:CHEMRX SALERNOS LLC
Other - Org Name:CHEMRX SALERNOS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECT DIR
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-409-5855
Mailing Address - Street 1:HC 1 BOX 30
Mailing Address - Street 2:
Mailing Address - City:SCIOTA
Mailing Address - State:PA
Mailing Address - Zip Code:18354-9701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BR 209 & BOSSARDSVILLE RD
Practice Address - Street 2:
Practice Address - City:SCIOTA
Practice Address - State:PA
Practice Address - Zip Code:18354
Practice Address - Country:US
Practice Address - Phone:570-992-6300
Practice Address - Fax:570-402-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336I0012X
PAPP415135L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7469209Medicaid
3973559OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY02887938Medicaid
PA0016671410001Medicaid
NJ7469209Medicaid