Healthcare Provider Details

I. General information

NPI: 1932293248
Provider Name (Legal Business Name): 8TH STREET PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 S 8TH ST
PHILADELPHIA PA
19147-2820
US

IV. Provider business mailing address

819 S 8TH ST
PHILADELPHIA PA
19147-2820
US

V. Phone/Fax

Practice location:
  • Phone: 215-592-8888
  • Fax: 215-592-9888
Mailing address:
  • Phone: 215-592-8888
  • Fax: 215-592-9888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP481623
License Number StatePA

VIII. Authorized Official

Name: ALEX LUONG
Title or Position: PRESIDENT
Credential: RPH
Phone: 215-592-8888