Organization
EASTERN REGIONAL MEDICAL CENTER INC
Active
Other names
Pharmacy & Nutrition Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER NGUYEN PHARMD (RETAIL PHARMACY MANAGER)
(215) 537-7626
Entity
Organization
Contact information
Practice address
1331 E WYOMING AVE, PHILADELPHIA, PA 19124-3808
(215) 537-7626
(215) 537-7987
Mailing address
1331 E WYOMING AVE, PHILADELPHIA, PA 19124-3808
(215) 537-7626
(215) 537-7987
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481912
PA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121072
PK
—
Enumeration date
07/15/2009
Last updated
04/17/2017
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