Organization
BOOTHWYN APOTHECARY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEL BOEHM (PHARMACIST IN CHARGE)
(610) 485-1130
Entity
Organization
Contact information
Practice address
2341 CHICHESTER AVE, UPPER CHICHESTER, PA 19061-3737
(610) 485-1130
Mailing address
2341 CHICHESTER AVE, UPPER CHICHESTER, PA 19061-3737
(610) 485-1130
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103281552-0001
—
PA
Enumeration date
11/04/2020
Last updated
11/04/2020
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