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Organization

LA VIDA DISCOUNT PHARMACY INC

Active
Other names
LA VIDA DISCOUNT PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICK ASSIFUAH (PHARMACY OWNER)
(862) 215-3414
Entity
Organization

Contact information

Practice address
3204 KENSINGTON AVE FL 1, 1ST FL, PHILADELPHIA, PA 19134-1918
(215) 427-1603
(215) 427-3590
Mailing address
3204 KENSIGNTON AVE, 1ST FL, PHILADELPHIA, PA 19134
(215) 427-1603

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PP482534
PA
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103007788
PA
01
2149600
PK
Enumeration date
01/07/2015
Last updated
09/19/2025
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