MEDICARE: ESSINGTON PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP482502	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2147947	OTHER		PK

General Provider Information

NPI Number	:	1124429725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSINGTON PHARMACY LLC

Provider Business Mailing Address
First Line	:	50 W POWHATTAN AVE STE 4
Second Line	:
City	:	ESSINGTON
State	:	PA
Zip	:	19029-1220
Country	:	US
Telephone Number	:	267-773-6082
Fax Number	:	610-537-7652

Provider Business Practice Location Address
First Line	:	50 W POWHATTAN AVE STE 4
Second Line	:
City	:	ESSINGTON
State	:	PA
Zip	:	19029-1220
Country	:	US
Telephone Number	:	267-773-6082
Fax Number	:	610-537-7652

Authorized Official
Title or Position	:	PIC
Name	:	PAUL BURRICHTER
Credential	:
Telephone Number	:	267-773-6082

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	04/11/2016

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Directions to “ESSINGTON PHARMACY LLC ” Practice Location

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