Individual
BO MI LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-2907
Mailing address
313 FOUNTAIN HALL CT, MOUNT LAUREL, NJ 08054-3715
(856) 343-8784
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI03639800
NJ
183500000X
Pharmacist
Primary
RP448875
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03639800
BOARD OF PHARMACY
NJ
01
—
28RJ05540
BOARD OF PHARMACY
NJ
01
—
RP448875
PA BOARD OF PHARMACY
PA
Enumeration date
12/02/2020
Last updated
12/02/2020
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