Organization
ACME MARKETS INC
Active
Other names
SAV-ON PHARMACY #0730
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
851 GAP NEWPORT PIKE, AVONDALE, PA 19311
(610) 268-8578
(610) 268-5968
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481769
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007619290094
—
PA
01
—
2082044
PK
—
Enumeration date
09/12/2007
Last updated
09/04/2018
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