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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