Organization
LIBERTY PHARMACY INC
Active
Other names
LIBERTY PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA OBASI (PRESIDENT)
(215) 927-4467
Entity
Organization
Contact information
Practice address
1926 E WASHINGTON LN, PHILADELPHIA, PA 19138-1230
(215) 927-4467
(215) 927-4469
Mailing address
1926 E WASHINGTON LN, PHILADELPHIA, PA 19138-1230
(215) 927-4467
(215) 927-4469
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP415390L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01692930
—
PA
01
—
2083811
PK
—
Enumeration date
04/10/2007
Last updated
10/16/2015
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