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Individual

CHRISTOPHER PHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
136 N 63RD ST, PHILADELPHIA, PA 19139-2201
(215) 472-7820
Mailing address
136 N 63RD ST, PHILADELPHIA, PA 19139-2201

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP448751
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPI008656
AUTHORIZATION TO ADMINISTER INJECTABLES
PA
Enumeration date
07/23/2014
Last updated
07/23/2014
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