MEDICARE: BUENA SALUD PHARMACY

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1184081390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUENA SALUD PHARMACY

Provider Business Mailing Address
First Line	:	3119 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-3820
Country	:	US
Telephone Number	:	215-426-5181
Fax Number	:

Provider Business Practice Location Address
First Line	:	3119 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-3820
Country	:	US
Telephone Number	:	215-426-5181
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	DR. OBIANUJU UZOMA ALLEN-MYAHWEGI
Credential	:
Telephone Number	:	215-426-5181

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	03/21/2018

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