Organization
DELUXE DRUG STORES LLC
Active
Other names
DELUXE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VENKATA BALAMURI (PHARMACY MANAGER)
(215) 941-7689
Entity
Organization
Contact information
Practice address
8749 FRANKFORD AVE, PHILADELPHIA, PA 19136-2126
(215) 941-7689
(215) 941-7893
Mailing address
8749 FRANKFORD AVE, PHILADELPHIA, PA 19136-2126
(215) 941-7689
(215) 941-7893
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482051
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025140600001
—
PA
01
—
3994337
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/24/2010
Last updated
04/11/2019
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