MEDICARE: LA FAMILIA 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
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1225465024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA FAMILIA PHARMACY INC.

Provider Business Mailing Address
First Line	:	2945 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-2802
Country	:	US
Telephone Number	:	215-425-4303
Fax Number	:	215-425-4306

Provider Business Practice Location Address
First Line	:	2945 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-2802
Country	:	US
Telephone Number	:	215-425-4303
Fax Number	:	215-425-4306

Authorized Official
Title or Position	:	MANAGER
Name	:	ENGIN CELIK
Credential	:
Telephone Number	:	267-939-1490

Provider Enumeration Date	:	10/11/2013
Last Update Date	:	10/11/2013

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