Organization
GOODHEART PHARMACY INC
Active
Other names
Goodheart pharmacy inc
Organization subpart
No
Provider details
NPI number
Authorized official
OBIOMA AGUOCHA (PHARMACIST INCHARGE)
(215) 724-3300
Entity
Organization
Contact information
Practice address
4835 WOODLAND AVE, PHILADELPHIA, PA 19143-4433
(215) 724-3300
(215) 724-3301
Mailing address
4835 WOODLAND AVE, PHILADELPHIA, PA 19143-4433
(215) 724-3300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482140
PA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025852210001
—
PA
01
—
2130575
PK
—
Enumeration date
05/31/2011
Last updated
08/16/2016
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