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Individual

BEVIS VANTERPOOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
4839 N BROAD ST, PHILADELPHIA, PA 19141-2107
(215) 324-0800
(215) 324-0801
Mailing address
4839 N BROAD ST, PHILADELPHIA, PA 19141-2107
(215) 324-0800
(215) 324-0801

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PP481991
PA

Other

Enumeration date
01/29/2010
Last updated
01/29/2010
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