Provider Demographics
NPI:1689397606
Name:NEXT GENERATION PHARMACY LLC
Entity type:Organization
Organization Name:NEXT GENERATION PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:IMRAN
Authorized Official - Last Name:FAROOQI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:610-269-7368
Mailing Address - Street 1:1169 HORSESHOE PIKE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1367
Mailing Address - Country:US
Mailing Address - Phone:610-269-7368
Mailing Address - Fax:610-269-2198
Practice Address - Street 1:1169 HORSESHOE PIKE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1367
Practice Address - Country:US
Practice Address - Phone:610-269-7368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEXT GENERATION PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-23
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030156450001Medicaid