MEDICARE: NEW GIRARD 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	PP-415198-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851414759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW GIRARD PHARMACY

Provider Business Mailing Address
First Line	:	4000 W GIRARD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-1032
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 W GIRARD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-1032
Country	:	US
Telephone Number	:	215-386-1594
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST MANAGER
Name	:	MASUD QURESHI
Credential	:
Telephone Number	:	215-386-1594

Provider Enumeration Date	:	04/08/2007
Last Update Date	:	08/22/2020

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Directions to “NEW GIRARD PHARMACY ” Practice Location

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