Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVNIA
Active
Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVNIA
Active
Parent organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Other names
Penn Medicine 76th Street Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Authorized official
GENEVIEVE LEVANS (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
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PP483087
STATE BOARD OF PHARMACY
PA
Enumeration date
02/01/2023
Last updated
02/01/2023
Update your record
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