Organization
MRLRX LLC
Active
Other names
Chestnut Hill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LAWSON (PRESIDENT)
(610) 485-7750
Entity
Organization
Contact information
Practice address
8030 GERMANTOWN AVE, PHILADELPHIA, PA 19118-3421
(215) 247-1221
(215) 247-1179
Mailing address
8030 GERMANTOWN AVE, PHILADELPHIA, PA 19118-3421
(215) 247-1221
(215) 247-1179
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482065
PA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3994628
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/09/2010
Last updated
11/02/2010
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