Organization
JAI SHRI KRISHNA LLC
Active
Other names
pennmark pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTIM PATEL (PHARMACY MANAGER)
(215) 735-1200
Entity
Organization
Contact information
Practice address
1735 SOUTH ST FL 1, PHILADELPHIA, PA 19146-1528
(215) 735-1200
(215) 735-0455
Mailing address
1735 SOUTH ST FL 1, PHILADELPHIA, PA 19146-1528
(215) 735-1200
(215) 735-0455
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482178
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175427
PK
—
Enumeration date
06/04/2011
Last updated
11/20/2018
About Stedi
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