Organization
LONG LANE DISCOUNT PHARMACY LLC
Active
Organization
LONG LANE DISCOUNT PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADEEP SURE (PIC)
(484) 469-4966
Entity
Organization
Contact information
Practice address
434 LONG LN, UPPER DARBY, PA 19082-5196
(484) 469-4966
(484) 469-4970
Mailing address
1501 E HIGH ST, POTTSTOWN, PA 19464-5005
(267) 664-5029
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/05/2020
Last updated
02/07/2024
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