Healthcare Provider Details

I. General information

NPI: 1184081390
Provider Name (Legal Business Name): BUENA SALUD PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3119 FRANKFORD AVE
PHILADELPHIA PA
19134-3820
US

IV. Provider business mailing address

3119 FRANKFORD AVE
PHILADELPHIA PA
19134-3820
US

V. Phone/Fax

Practice location:
  • Phone: 215-426-5181
  • Fax:
Mailing address:
  • Phone: 215-426-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. OBIANUJU UZOMA ALLEN-MYAHWEGI
Title or Position: PHARMACIST
Credential:
Phone: 215-426-5181