Organization
SDARBOUZE APOTHECARY INC.
Active
Other names
Broad & Amp; Grange Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D IVEY JR. (OWNER)
(215) 424-2611
Entity
Organization
Contact information
Practice address
5751 N BROAD ST STE 3, PHILADELPHIA, PA 19141-2302
(215) 424-2611
Mailing address
5751 N BROAD ST STE 3, PHILADELPHIA, PA 19141-2302
(215) 424-2611
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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