Organization
HILLRISE PHARMACY LLC
Active
Other names
HillRise Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
OMOTAYO OLUFEMI BADEJOKO (PHARMACY MANAGER/OWNER)
(215) 403-7300
Entity
Organization
Contact information
Practice address
4240 N BROAD ST, PHILADELPHIA, PA 19140-1908
(215) 403-7300
(267) 335-3937
Mailing address
7817 CHELTENHAM AVE, LAVEROCK, PA 19038-7621
(484) 326-1877
(267) 335-3937
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103114017
—
PA
Enumeration date
05/14/2021
Last updated
05/14/2021
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