Healthcare Provider Details

I. General information

NPI: 1356630875
Provider Name (Legal Business Name): TOPICAL APOTHECARY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 06/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 PRIMOS AVE STE E
FOLCROFT PA
19032-2000
US

IV. Provider business mailing address

780 PRIMOS AVE STE E
FOLCROFT PA
19032-2000
US

V. Phone/Fax

Practice location:
  • Phone: 484-477-0700
  • Fax: 610-522-9006
Mailing address:
  • Phone: 484-477-0700
  • Fax: 610-522-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP482153
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICH MOSSER
Title or Position: OWNER
Credential:
Phone: 610-888-7619