Organization
I & L EXPRESS PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA MINKOVICH RPH (PHARMACIST)
(215) 677-0100
Entity
Organization
Contact information
Practice address
9977 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
(215) 677-0100
Mailing address
9977 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP481381
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010567290001
—
PA
01
—
3983423
NCPDP
PA
Enumeration date
03/27/2007
Last updated
03/07/2023
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