Provider Demographics
NPI:1043946288
Name:BIRDSBORO PHARMACY INC
Entity type:Organization
Organization Name:BIRDSBORO PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KENDRA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-582-4005
Mailing Address - Street 1:200 W 1ST ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-2254
Mailing Address - Country:US
Mailing Address - Phone:610-582-4005
Mailing Address - Fax:
Practice Address - Street 1:200 W 1ST ST STE 3A
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-2254
Practice Address - Country:US
Practice Address - Phone:610-582-4005
Practice Address - Fax:610-404-4512
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIRDSBORO PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy