Organization
MAYFAIR DRUG STORE INC
Active
Other names
MAYFAIR DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PRISTAS (PHARMACIST)
(215) 338-2626
Entity
Organization
Contact information
Practice address
7522 FRANKFORD AVE, PHILADELPHIA, PA 19136-3533
(215) 338-2626
(215) 338-5209
Mailing address
7522 FRANKFORD AVE, PHILADELPHIA, PA 19136-3533
(215) 338-2626
(215) 338-5209
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481504
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014416570001
—
PA
01
—
3985085
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/04/2006
Last updated
01/23/2012
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