Healthcare Provider Details

I. General information

NPI: 1043215106
Provider Name (Legal Business Name): SLAKOPER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 BRISTOL PIKE
CROYDON PA
19021-5412
US

IV. Provider business mailing address

701 BRISTOL PIKE
CROYDON PA
19021-5412
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-3537
  • Fax: 215-781-9995
Mailing address:
  • Phone: 215-785-3537
  • Fax: 215-781-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP410704L
License Number StatePA

VIII. Authorized Official

Name: JENNIFER BOWMAN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 215-785-3537