Provider Demographics
NPI:1427878743
Name:DOOKIE BOYZ LLC
Entity type:Organization
Organization Name:DOOKIE BOYZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-678-7733
Mailing Address - Street 1:6201 N FRONT ST UNIT 123
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1541
Mailing Address - Country:US
Mailing Address - Phone:215-706-8880
Mailing Address - Fax:215-706-8881
Practice Address - Street 1:6201 N FRONT ST UNIT 123
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-1541
Practice Address - Country:US
Practice Address - Phone:215-706-8880
Practice Address - Fax:215-706-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy