Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Other names
Penn Medicine 76th Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE LEVANS RPH (ASSOCIATE DIRECTOR)
(215) 796-2085
Entity
Organization
Contact information
Practice address
3250 S 76TH ST STE 400, PHILADELPHIA, PA 19153-3255
(215) 594-8100
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 796-2085
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PP483087
STATE BOARD OF PHARMACY
PA
Enumeration date
08/02/2022
Last updated
08/02/2022
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