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INDEPENDENT RX INCORPORATED NPI 1992141030


NPI Information

NPI: 1992141030
Provider Name: INDEPENDENT RX INCORPORATED

Doing Business As: CENTENNIAL PHARMACY-QUEEN VILLAGE

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 39D2260026

Address:
843 S 2ND ST STE 2
PHILADELPHIA, PA
ZIP 19147
Phone: (267) 324-5347
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INDEPENDENT RX INCORPORATED is a community/retail pharmacy pharmacy in Philadelphia, PA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. INDEPENDENT RX INCORPORATED NPI is 1992141030. The provider is registered as an organization entity type.
The provider Is Doing Business As Centennial Pharmacy-queen Village.

The provider's business location address is:

843 S 2ND ST STE 2
PHILADELPHIA, PA
ZIP 19147-445
Phone: (267) 324-5347
Fax: (267) 324-5418

The provider's authorized official is Joseph Dymowski .
The authorized official title is President/owner and has the following contact phone number (267) 324-5347.

The CLIA number assigned to this NPI record is 39D2260026 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2013 and was last updated on 11/23/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPP482369PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12138507OTHERPK
2102466113002MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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