# HILLRISE PHARMACY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** HillRise Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104490143
- **Authorized official:** OMOTAYO OLUFEMI BADEJOKO (PHARMACY MANAGER/OWNER)
- **Authorized official phone:** (215) 403-7300

## Contact information

- **Practice address:** 4240 N BROAD ST, PHILADELPHIA, PA 19140-1908
- **Practice address phone:** (215) 403-7300
- **Practice address fax:** (267) 335-3937
- **Mailing address:** 7817 CHELTENHAM AVE, LAVEROCK, PA 19038-7621
- **Mailing address phone:** (484) 326-1877
- **Mailing address fax:** (267) 335-3937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2021
- **Last updated:** 05/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103114017 | — | PA |