Organization
PHILLY PHARMACY II, LLC
Active
Organization
PHILLY PHARMACY II, LLC
Active
Other names
Philly Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GARCIA (PHARMACY MANAGER)
(215) 969-5180
Entity
Organization
Contact information
Practice address
9475 ROOSEVELT BLVD STE 12, PHILADELPHIA, PA 19114-2212
(215) 625-6668
(866) 379-3198
Mailing address
9475 ROOSEVELT BLVD, STE 12, PHILADELPHIA, PA 19114-2212
(215) 625-6668
(866) 379-3198
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482144
PA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3995480
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/20/2011
Last updated
05/20/2011
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