Healthcare Provider Details

I. General information

NPI: 1114249166
Provider Name (Legal Business Name): PHARMACY PARTNERSHIP 2 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 N BROAD ST
PHILADELPHIA PA
19141-2308
US

IV. Provider business mailing address

2400 W PASSYUNK AVE
PHILADELPHIA PA
19145-4114
US

V. Phone/Fax

Practice location:
  • Phone: 267-687-7612
  • Fax:
Mailing address:
  • Phone: 215-880-7905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP481986
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HAFIZ EBADY
Title or Position: CEO
Credential:
Phone: 215-880-7905