Organization
52ND STREET PHARMACY INC
Active
Other names
52ND STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
OLALEKAN ABIFARIN (OWNER)
(267) 713-7066
Entity
Organization
Contact information
Practice address
1226 N 52ND ST, PHILADELPHIA, PA 19131-4315
(267) 713-7066
(215) 921-2708
Mailing address
1226 N 52ND ST, PHILADELPHIA, PA 19131-4315
(610) 704-8594
(215) 921-2708
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482438
PA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144460
PK
—
Enumeration date
03/03/2014
Last updated
08/01/2014
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