Healthcare Provider Details

I. General information

NPI: 1518707413
Provider Name (Legal Business Name): ANNA GRACE ZUSCHNITT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-5127
US

IV. Provider business mailing address

1136 N AMERICAN ST UNIT 410
PHILADELPHIA PA
19123-1680
US

V. Phone/Fax

Practice location:
  • Phone: 215-410-1014
  • Fax:
Mailing address:
  • Phone: 215-378-3816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP454731
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: