Organization · Type 2 NPI

Ehpp Chestnut Ridge LLC

Non-Pharmacy Dispensing Site · New Alexandria, PA

NPI number 1275770273 Active

Practice location

401 Main St
New Alexandria, PA 15670

Call (724) 668-7147 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	MD023700 (PA)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

NPI record

NPI: 1275770273
Entity type: Organization (Type 2)
Issued: Jan 13, 2009
Last updated: Oct 23, 2012
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

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Excela Chestnut Ridge New Alexandria · doing business as

Authorized official

Kenny Heine
Director of Operations
(858) 625-2990

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1275770273

Ehpp Chestnut Ridge LLC's National Provider Identifier is 1275770273, issued on Jan 13, 2009. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in New Alexandria, PA. The record was last updated on Oct 23, 2012.