Organization
FKATAN LLC
Active
Organization
FKATAN LLC
Active
Other names
LN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AYALEW TASSEW PHARMD (PHARMACY MANAGER)
(202) 365-5070
Entity
Organization
Contact information
Practice address
5927 LANSDOWNE AVE FL 1, PHILADELPHIA, PA 19151-3932
(215) 473-0750
(215) 473-1804
Mailing address
1607 S KEYSTONE AVE, UPPER DARBY, PA 19082-3514
(215) 473-0750
(215) 473-1804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP482650
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103104360-0001
—
PA
Enumeration date
05/26/2016
Last updated
06/04/2025
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