Organization
NISENHOLTZ PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES V REGINELLI R.PH. (OWNER/PHARMACY MANAGER)
(215) 342-7676
Entity
Organization
Contact information
Practice address
7624 CASTOR AVE, PHILADELPHIA, PA 19152-3623
(215) 342-7676
(215) 342-1593
Mailing address
7624 CASTOR AVE, PHILADELPHIA, PA 19152-3623
(215) 342-7676
(215) 342-1593
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP411697L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012629200001
—
PA
01
—
1912629201
PA ACCESS
PA
01
—
3963762
NCPDP NUMBER
—
01
—
PP411697L
PA STATE LICENSE
PA
Enumeration date
03/27/2006
Last updated
02/14/2008
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