Healthcare Provider Details

I. General information

NPI: 1659783660
Provider Name (Legal Business Name): MEGAN HOLLINGSWORTH PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2014
Last Update Date: 05/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5911 RIDGE AVE
PHILADELPHIA PA
19128-1642
US

IV. Provider business mailing address

5911 RIDGE AVE
PHILADELPHIA PA
19128-1642
US

V. Phone/Fax

Practice location:
  • Phone: 215-482-1992
  • Fax: 215-482-9146
Mailing address:
  • Phone: 215-482-1992
  • Fax: 215-482-9146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP446273
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPI006107
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: