Organization
PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #4
Active
Other names
Pharmacy Health Center #4
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY T. PENDER RPH (DIRECTOR OF PHARMACEUTICAL SERVICES)
(215) 685-6864
Entity
Organization
Contact information
Practice address
4400 HAVERFORD AVENUE, PHARMACY, PHILADELPHIA, PA 19104
(215) 685-7926
Mailing address
500 S. BROAD STREET, PHARMACY/BASEMENT, PHILADELPHIA, PA 19146
(215) 685-6864
(215) 790-1651
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
HP418324L
PA
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000076950039
—
PA
Enumeration date
10/04/2006
Last updated
03/07/2019
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