Organization
OLIVE TREE HEALTHCARE LLC
Active
Other names
OLIVE TREE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADIGUN OLATUBOSUN ITABIYI RPH (PHARMACIST MANAGER)
(610) 257-3105
Entity
Organization
Contact information
Practice address
253 S 60TH ST, PHILADELPHIA, PA 19139-3844
(610) 257-3105
(610) 257-3104
Mailing address
253 S 60TH ST, PHILADELPHIA, PA 19139-3844
(610) 257-3105
(610) 257-3104
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103935262-0001
—
PA
Enumeration date
03/16/2021
Last updated
09/24/2024
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