Organization
INNOVIANT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MCCANN (PRES)
(267) 725-3004
Entity
Organization
Contact information
Practice address
1800 BYBERRY RD, STE 1202, HUNTINGDON VALLEY, PA 19006-3518
(215) 947-8169
(888) 215-6779
Mailing address
1800 BYBERRY RD, STE 1202, HUNTINGDON VALLEY, PA 19006-3518
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP412934L
PA
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3966085
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/02/2007
Last updated
07/31/2007
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