Healthcare Provider Details

I. General information

NPI: 1336356526
Provider Name (Legal Business Name): ROBERTS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2377 HAVERFORD ROAD
ARDMORE PA
19003
US

IV. Provider business mailing address

2377 HAVERFORD ROAD
ARDMORE PA
19003
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-4788
  • Fax: 610-642-6807
Mailing address:
  • Phone: 610-642-4788
  • Fax: 610-642-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0187132
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP412104L
License Number StatePA

VIII. Authorized Official

Name: MR. LEONARD J MOSKOWITZ
Title or Position: OWNER
Credential:
Phone: 610-642-4788