Healthcare Provider Details

I. General information

NPI: 1033080361
Provider Name (Legal Business Name): ELVIS XHEPA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 10/24/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W CHELTEN AVE
PHILADELPHIA PA
19144-3302
US

IV. Provider business mailing address

3438 MERCER ST
PHILADELPHIA PA
19134-5342
US

V. Phone/Fax

Practice location:
  • Phone: 215-848-4651
  • Fax:
Mailing address:
  • Phone: 215-848-4651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459672
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: