Organization
LIFESTREAM PHARMACY INC
Active
Other names
LIFESTREAM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIOS MELEKOS PHARMACY (OWNER/PHCY MGR)
(215) 491-0999
Entity
Organization
Contact information
Practice address
847 EASTON RD, WARRINGTON, PA 18976-2906
(215) 491-0999
(215) 491-0977
Mailing address
847 EASTON RD, WARRINGTON, PA 18976-2906
(215) 491-0999
(215) 491-0977
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481543
PA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015654020001
—
PA
01
—
2087685
PK
—
Enumeration date
07/12/2006
Last updated
03/24/2017
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