MEDICARE: JUST HERE II; 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	3336C0003X	Community/Retail Pharmacy	PP482015	PA

General Provider Information

NPI Number	:	1356667240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST HERE II; LLC

Provider Business Mailing Address
First Line	:	2909 N 22ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-1505
Country	:	US
Telephone Number	:	215-226-8530
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 N 22ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-1505
Country	:	US
Telephone Number	:	215-226-8530
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	DR. KWABENA ASAFO BOAKYE
Credential	:	PHARM D.
Telephone Number	:	215-226-8530

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	04/16/2010

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Directions to “JUST HERE II; LLC ” Practice Location

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