Organization
ANGKOR PHARMACY LLC
Active
Other names
Angkor Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN NGO (OWNER)
(215) 760-4214
Entity
Organization
Contact information
Practice address
2129-31 S. 7TH STREET, PHILADELPHIA, PA 19148
(267) 928-2600
(267) 928-2841
Mailing address
2129-31 S. 7TH STREET, PHILADELPHIA, PA 19148
(267) 928-2600
(267) 928-2841
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482423
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028841500001
—
PA
01
—
2143403
PK
—
Enumeration date
11/05/2013
Last updated
09/30/2014
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