Innovative Pharmacy LLC
Pharmacy, Long Term Care Pharmacy in Bristol, PA. Organization (NPI-2).
NPI number1497017461
StatusActive
Last updated in NPPESAug 22, 2012
Details
- NPI
- 1497017461
- Entity type
- Organization (NPI-2)
- Legal business name
- Innovative Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Jun 14, 2012
- Last updated
- Aug 22, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | PP482279 | PA | Yes |
| 3336C0004X | Pharmacy, Compounding Pharmacy | – | – | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Innovative Pharmacy (Doing Business As)
Practice location
2014 Ford Rd Ste BBristol, PA 19007-6743
Phone 267-878-0492 · Fax 267-878-0534
Mailing address
2014 Ford RoadUnit B
Bristol, PA 19007
Phone 267-878-0492 · Fax 267-878-0534
Authorized official
Evan Landa
Managing Member
9082166680
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