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NPI Code Detail

MEDICARE: GILEAD PHARMACY INC

MEDICARE: GILEAD PHARMACY INC
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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPP482775PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12176474OTHERPK

General Provider Information

NPI Number : 1154827103
Entity Type Code : Organization
Provider Name (Legal Business Name) : GILEAD PHARMACY INC
Provider Business Mailing Address
First Line : 1226 N 52ND ST. FL 1
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-4315
Country : US
Telephone Number : 267-713-7066
Fax Number : 215-921-2708
Provider Business Practice Location Address
First Line : 1226 N 52ND ST FL 1
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-4315
Country : US
Telephone Number : 267-713-7066
Fax Number : 215-921-2708
Authorized Official
Title or Position : STORE MGR, AO
Name : FOLUKE ODUSEUN
Credential :
Telephone Number : 267-439-8292
Provider Enumeration Date : 03/30/2018
Last Update Date : 07/19/2018

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Directions to “GILEAD PHARMACY INC ” Practice Location

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