| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | SURNIL PHARMACY, INC · Surnil Pharmacy, Inc. | [sources] | |||
| Alias | Haussemanns Pharmacy | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | OTHER BUSINESS · PHARMACY | [sources] | |||
| ID Number | PP481705 | [sources] | |||
| NPI | 1053528422 | [sources] | |||
| Registration number | not available | [sources] | |||
| Tax Number | 208425236 | [sources] | |||
| Address | 1207 N 5TH ST, PHILADELPHIA, PA 19122 · Philadelphia, PA | [sources] | |||
| Last change | Last processed | First seen | |||
List of providers excluded from participating in the Delaware Medicaid program.
United States · DHSS
Medical providers who are precluded from participation in the Medical Assistance Program
United States · DHS
People and companies excluded from Federally funded health care programs
United States · OIG
us-medpa-c11ef25c88e00649ec35a1c90832daadc25d6cbc · us-fed-excl-surnil-pharmacy-inc-19122-philadelphia · us-medde-a78c80bd9bece6f8f0a172790051995315a411b9For experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| Philadelphia, PA | United States | |
| United States | Pennsylvania Department of Human Services | - |
| United States | Department of Health and Human Services Office of Inspector General | List of Excluded Individuals/Entities (LEIE) | - |