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General NPI Number Information
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NPI Number | 1003954488
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Entity Type | Organization
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Legal Business Name | WYCOMBE PHARMACY INC.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1006 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19133-1640
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Country | US
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Telephone | 215-225-7522
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Fax | 215-225-7525
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Provider Business Mailing Address
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Address Line | 1006 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19133-1640
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Country | US
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Telephone | 215-225-7522
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Fax | 215-225-7525
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Authorized Official
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Title or Position | PHARMACIST & OWNER
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Name | MR. PAUL CARMEN SCOTA
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Credential | R.PH.
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Telephone | 215-225-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PP481048
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License Number State | PA
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