Organization
2209 MACDADE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAN WALKER (MEMBER)
(610) 328-5778
Entity
Organization
Contact information
Practice address
2209 MACDADE BLVD, HOLMES, PA 19043-1222
(610) 461-4123
(610) 461-2796
Mailing address
2209 MACDADE BLVD, HOLMES, PA 19043-1222
(610) 461-4123
(610) 461-2796
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP413732L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034071350001
—
PA
01
—
2171616
PK
—
Enumeration date
09/11/2017
Last updated
04/26/2018
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