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Organization

PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY STRAWBERRY

Active
Other names
Pharmacy Strawberry Mansion Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY T. PENDER RPH (DIRECTOR OF PHARMACEUTICAL SERVICES)
(215) 685-6864
Entity
Organization

Contact information

Practice address
2840 W DAUPHIN STREET, PHILADELPHIA, PA 19132
(215) 685-2419
Mailing address
500 S. BROAD STREET, PHARMACY/BASEMENT, PHILADELPHIA, PA 19146
(215) 685-6864
(215) 790-1651

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
PP413927L
PA
261QF0400X
Federally Qualified Health Center (FQHC)
PA
3336C0002X
Clinic Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000076950082
PA
Enumeration date
10/27/2006
Last updated
03/07/2019
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