Organization
BROAD ST PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MORRIS J WHITE SR. RPH (OWNER RPH)
(215) 755-2010
Entity
Organization
Contact information
Practice address
1412 S BROAD ST, PHILADELPHIA, PA 19146
(215) 755-2010
(215) 940-1266
Mailing address
1412 S BROAD ST, PHILADELPHIA, PA 19146
(215) 755-2010
(215) 940-1266
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP414363L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121699
—
PA
01
—
3961047
NABP
PA
Enumeration date
04/17/2007
Last updated
08/21/2007
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