Organization
TIRELLI INC
Active
Other names
BROAD STREET APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL TIROTTO RPH (PRESIDENT)
(215) 551-9485
Entity
Organization
Contact information
Practice address
2426 S BROAD ST, PHILADELPHIA, PA 19145-4418
(215) 551-9485
(215) 468-7189
Mailing address
2426 S BROAD ST, PHILADELPHIA, PA 19145-4418
(215) 551-9485
(215) 468-7189
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP414268L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1182580
—
PA
01
—
2079620
PK
—
Enumeration date
11/03/2006
Last updated
02/22/2016
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