Organization
AVENUE HEALTHCARE ENTERPRISES INC
Active
Other names
Avenue Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAYODE EBED-MELECH BALOGUN SR. R.PH, M.SC (PRESIDENT/CEO)
(484) 816-0344
Entity
Organization
Contact information
Practice address
1111 AVENUE OF THE STATES, STORE #2, CHESTER, PA 19013
(484) 816-0344
(484) 816-0296
Mailing address
1111 AVENUE OF THE STATES, CHESTER, PA 19013
(484) 816-0344
(484) 816-0296
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024548380001
—
PA
01
—
333600000X
PHARMACY
PA
Enumeration date
05/07/2010
Last updated
01/28/2022
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