Healthcare Provider Details

I. General information

NPI: 1285496349
Provider Name (Legal Business Name): URBANCARE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 W LEHIGH AVE
PHILADELPHIA PA
19133-3832
US

IV. Provider business mailing address

169 W LEHIGH AVE
PHILADELPHIA PA
19133-3832
US

V. Phone/Fax

Practice location:
  • Phone: 267-858-4662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH JOHN URBAN
Title or Position: OWNER
Credential:
Phone: 267-858-4662