Organization
INDEPENDENT APOTHECARY INCORPORATED
Active
Other names
OLDE PHILLY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CIRILLO (PRESIDENT/OWNER)
(215) 739-0548
Entity
Organization
Contact information
Practice address
2923 E THOMPSON ST, PHILADELPHIA, PA 19134-4812
(215) 739-0548
(215) 739-1579
Mailing address
2923 E THOMPSON ST, 1ST FLR FRONT, PHILADELPHIA, PA 19134-4812
(215) 739-0548
(215) 739-1579
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481544
PA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015440460001
—
PA
01
—
2087681
PK
—
Enumeration date
07/21/2006
Last updated
07/01/2024
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