Organization
G&A SOMERTON PHARMACY LLC
Active
Other names
SOMERTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
INESSA LERNER (PIC)
(215) 969-9700
Entity
Organization
Contact information
Practice address
10806 BUSTLETON AVE, PHILADELPHIA, PA 19116
(215) 969-9700
(215) 969-3905
Mailing address
10806 BUSTLETON AVE, PHILADELPHIA, PA 19116-3302
(215) 969-9700
(215) 969-3905
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481423
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011950430001
—
PA
01
—
2087052
PK
—
Enumeration date
12/04/2006
Last updated
07/11/2018
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