Organization
CITY LINE PHARMACY LLC
Active
Other names
City Line Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HAJIRA EBADY PHARM.D. (MANAGER)
(610) 664-7100
Entity
Organization
Contact information
Practice address
150 MONUMENT RD STE 601C, BALA CYNWYD, PA 19004-1701
(610) 664-7100
(866) 403-7224
Mailing address
150 MONUMENT RD STE 601C, BALA CYNWYD, PA 19004-1701
(610) 664-7100
(866) 403-7224
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482244
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143847
PK
—
Enumeration date
03/23/2012
Last updated
02/17/2015
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