Organization
ACME MARKETS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMOND HAWKINS (THIRD PARTY MANAGER)
(208) 395-3905
Entity
Organization
Contact information
Practice address
222 E MAIN ST, COLLEGEVILLE, PA 19426-2650
(610) 409-9053
(610) 409-2998
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP414949L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007619290037
—
PA
01
—
3968849
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/25/2006
Last updated
01/19/2018
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