Provider Demographics
NPI:1104465764
Name:PENNINGTON PHARMACY LLC
Entity type:Organization
Organization Name:PENNINGTON PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JATIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-882-2404
Mailing Address - Street 1:2108 PENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-1416
Mailing Address - Country:US
Mailing Address - Phone:609-882-2404
Mailing Address - Fax:609-882-4220
Practice Address - Street 1:2108 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-1416
Practice Address - Country:US
Practice Address - Phone:609-882-2404
Practice Address - Fax:609-882-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy