Organization
MY PHILLY PHARMACY INC
Active
Other names
Olde Philly Pharmacy - Fishtown
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CIRILLO (PRESIDENT)
(609) 560-8082
Entity
Organization
Contact information
Practice address
3140 WILLITS RD, PHILADELPHIA, PA 19136-1116
(267) 686-2454
(267) 773-7832
Mailing address
3140 WILLITS RD, PHILADELPHIA, PA 19136-1116
(267) 686-2454
(267) 773-7832
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482381
PA
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028277800001
—
PA
01
—
2140615
PK
—
Enumeration date
06/05/2013
Last updated
09/01/2016
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