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Contact Information

PRIMARY CHOICE PHARMACY LLC
5575 OLD YORK RD
PHILADELPHIA, PA19141
 Phone: 215-437-9043
 Fax: 215-437-9045
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for PRIMARY CHOICE PHARMACY LLC

NPI # 1194126128
LBN Legal business name PRIMARY CHOICE PHARMACY LLC
Authorized official EMMANUIL SHAMILOV - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/09/2014
Last updated 07/08/2025 - About 11 months ago
Identifiers
PA License # PP482510
PA Medicaid 1029774280002
PA Other 1194126128 DURABLE MEDICAL EQUIPMENT
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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