Organization
FOUR STAR PHARMACY II LLC
Active
Other names
FOUR STAR PHARMACY II LLC DBA TOTAL FAMILY PHARMACY, TOTAL FAMILY PHARMACY, Four Star Pharmacy II
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IYABODE LEAH ADEWALE PHARM.D (PHARMACIST)
(215) 877-2400
Entity
Organization
Contact information
Practice address
6542 LEBANON AVE, PHILADELPHIA, PA 19151-3328
(215) 877-2400
(215) 877-2403
Mailing address
6542 LEBANON AVE APT A, PHILADELPHIA, PA 19151-3337
(215) 877-2400
(215) 877-2403
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482266
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027396500001
—
PA
01
—
2135081
PK
—
Enumeration date
04/27/2012
Last updated
01/08/2025
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