Provider Demographics
NPI:1386346401
Name:MEDPLUS PHARMACY INC
Entity type:Organization
Organization Name:MEDPLUS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VASILIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PALENGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-941-1220
Mailing Address - Street 1:2410 RHAWN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3324
Mailing Address - Country:US
Mailing Address - Phone:215-941-1220
Mailing Address - Fax:215-904-7870
Practice Address - Street 1:2410 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3324
Practice Address - Country:US
Practice Address - Phone:215-941-1220
Practice Address - Fax:215-904-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy