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Organization

CREST CENTER PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID MITTAL (OWNER)
(215) 915-6075
Entity
Organization

Contact information

Practice address
240 FITZWATERTOWN RD, WILLOW GROVE, PA 19090-2332
(215) 658-1216
(610) 658-1217
Mailing address
240 FITZWATERTOWN RD, WILLOW GROVE, PA 19090-2332

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PP481086
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007428070002
PA
01
3979703
OTHER ID NUMBER
Enumeration date
08/09/2005
Last updated
11/13/2007
About Stedi
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  • Eligibility checks
  • EDI platform