Organization
LIFESTREAM PHARMACY INC
Active
Other names
LIFESREAM RX
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIOS MELEKOS RPH (OWNER)
(215) 491-0979
Entity
Organization
Contact information
Practice address
847 EASTON RD, STE 2775, WARRINGTON, PA 18976-2906
(215) 491-0979
(215) 491-0977
Mailing address
847 EASTON RD, STE 2775, WARRINGTON, PA 18976-2906
(215) 491-0979
(215) 491-0977
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PP481713
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015654020002
—
PA
01
—
2081797
PK
—
Enumeration date
04/25/2007
Last updated
03/24/2017
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