Provider Demographics
NPI:1760272421
Name:PROSPECTVILLE PHARMACY LTC
Entity type:Organization
Organization Name:PROSPECTVILLE PHARMACY LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTH OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:NILESH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROKAD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:267-218-4747
Mailing Address - Street 1:1116 HORSHAM RD STE 8
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-1143
Mailing Address - Country:US
Mailing Address - Phone:215-970-9776
Mailing Address - Fax:215-970-9776
Practice Address - Street 1:1116 HORSHAM RD STE 8
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-1143
Practice Address - Country:US
Practice Address - Phone:215-970-9776
Practice Address - Fax:215-970-9776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORSHAM RX LLC DBA PROSPECTVILLE PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy