Organization
SUBURBAN BUSTLETON PHARMACY INC.
Active
Other names
Suburban Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE DZIERZA (OWNER)
(215) 673-0994
Entity
Organization
Contact information
Practice address
10875 BUSTLETON AVENUE, PHILADELPHIA, PA 19116-3301
(215) 673-0994
(215) 969-6176
Mailing address
10875 BUSTLETON AVE, PHILADELPHIA, PA 19116-3301
(215) 673-0994
(215) 969-6176
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP412433L
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP412433L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014348470001
—
PA
Enumeration date
12/05/2006
Last updated
01/21/2026
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