Healthcare Provider Details

I. General information

NPI: 1033803697
Provider Name (Legal Business Name): SALIMATOU JAWARA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N 12TH ST UNIT F
PHILADELPHIA PA
19122-2585
US

IV. Provider business mailing address

1900 ARCH ST APT 519
PHILADELPHIA PA
19103-1535
US

V. Phone/Fax

Practice location:
  • Phone: 215-235-2001
  • Fax:
Mailing address:
  • Phone: 603-727-9281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP454278
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: