Provider Demographics
NPI:1467295584
Name:MEDIPACK PHARMACY OPERATOR LLC
Entity type:Organization
Organization Name:MEDIPACK PHARMACY OPERATOR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-905-6440
Mailing Address - Street 1:3917 WESTPOINT BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6723
Mailing Address - Country:US
Mailing Address - Phone:336-773-1013
Mailing Address - Fax:336-773-1217
Practice Address - Street 1:3917 WESTPOINT BLVD STE A
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6723
Practice Address - Country:US
Practice Address - Phone:336-773-1013
Practice Address - Fax:336-773-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy