Organization
EXPRESS DISCOUNT PHARMACY LLC
Active
Other names
Express Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAVITHRAN GUJJA (PHARMACIST IN-CHARGE/MEMBER)
(302) 575-9891
Entity
Organization
Contact information
Practice address
4528 KIRKWOOD HWY STE A, WILMINGTON, DE 19808-5126
(302) 575-9891
(302) 575-9893
Mailing address
4528 KIRKWOOD HWY, STE A, WILMINGTON, DE 19808-5126
(302) 575-9891
(302) 575-9893
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
A3-0001000
DE
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760843734
—
DE
01
—
2158882
PK
—
Enumeration date
03/17/2016
Last updated
03/24/2022
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