# LIFESTREAM PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIFESREAM RX
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730308826
- **Authorized official:** DEMETRIOS MELEKOS RPH (OWNER)
- **Authorized official phone:** (215) 491-0979

## Contact information

- **Practice address:** 847 EASTON RD, STE 2775, WARRINGTON, PA 18976-2906
- **Practice address phone:** (215) 491-0979
- **Practice address fax:** (215) 491-0977
- **Mailing address:** 847 EASTON RD, STE 2775, WARRINGTON, PA 18976-2906
- **Mailing address phone:** (215) 491-0979
- **Mailing address fax:** (215) 491-0977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PP481713 | PA | Yes |

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 03/24/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1015654020002 | — | PA |
| 01 | — | 2081797 | PK | — |