Organization
DELUXE DRUG STORES LLC
Active
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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