Organization
5 STAR PHARMACY & MEDICAL SUPPLY INC
Active
Organization
5 STAR PHARMACY & MEDICAL SUPPLY INC
Active
Other names
5 Star Pharmacy & Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO RODRIGUEZ (PRESIDENT)
(267) 997-1220
Entity
Organization
Contact information
Practice address
209 2ND STREET PIKE, SOUTHAMPTON, PA 18966-3833
(215) 355-2004
(215) 355-6001
Mailing address
209 2ND STREET PIKE, SOUTHAMPTON, PA 18966-3833
(215) 355-2004
(215) 355-6001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482329
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029812060001
—
PA
01
—
2148058
PK
—
Enumeration date
11/06/2012
Last updated
04/19/2017
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