Healthcare Provider Details

I. General information

NPI: 1285354993
Provider Name (Legal Business Name): MICHAEL ANTHONY BELPERIO III PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 W OREGON AVE
PHILADELPHIA PA
19145-4122
US

IV. Provider business mailing address

1734 S 11TH ST # 2
PHILADELPHIA PA
19148-1636
US

V. Phone/Fax

Practice location:
  • Phone: 215-468-2481
  • Fax:
Mailing address:
  • Phone: 856-230-8615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP457122
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: