Organization
EDDYSTONE COMMUNITY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGDALIAH JACKSON PHARMD (PHARMACIST/OWNER)
(484) 480-3341
Entity
Organization
Contact information
Practice address
1207B CHESTER PIKE, EDDYSTONE, PA 19022-1332
(484) 480-3341
(484) 480-3344
Mailing address
1207B CHESTER PIKE, EDDYSTONE, PA 19022-1332
(484) 480-3341
(484) 480-3344
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
—
—
1835G0303X
Geriatric Pharmacist
—
—
1835N1003X
Nutrition Support Pharmacist
—
—
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PP482215
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP482215
PA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
02/03/2012
Last updated
08/06/2012
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