Organization
SOUSAN PHARMACY INC
Active
Other names
SOUSAN PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOTT HAAZ RPH (OWNER AND PRESIDENT)
(215) 635-4200
Entity
Organization
Contact information
Practice address
8029 OLD YORK RD, ELKINS PARK, PA 19027-1413
(215) 635-4200
(215) 635-3654
Mailing address
8029 OLD YORK RD, ELKINS PARK, PA 19027-1413
(215) 635-4200
(215) 635-3654
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP412344L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3914024
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/27/2005
Last updated
07/01/2010
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