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General NPI Number Information
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NPI Number | 1013337682
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Entity Type | Organization
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Legal Business Name | PHILARX PHARMACY 5
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 2400 W PASSYUNK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19145-4114
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Country | US
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Telephone | 267-928-2149
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 W PASSYUNK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19145-4114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HAFIZ EBADY
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Credential |
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Telephone | 609-772-1314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482388
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License Number State | PA
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