Healthcare Provider Details

I. General information

NPI: 1780507103
Provider Name (Legal Business Name): DAVID BIALEK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 WEDGEWOOD LN
MEDIA PA
19063-5534
US

IV. Provider business mailing address

416 WEDGEWOOD LN
MEDIA PA
19063-5534
US

V. Phone/Fax

Practice location:
  • Phone: 215-688-6768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRP045684L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: