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General NPI Number Information
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NPI Number | 1013349323
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Entity Type | Organization
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Legal Business Name | CHESTER PIKE PHARMACY LLC
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 637 MACDADE BLVD
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City | COLLINGDALE
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State | PA
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Zip | 19023-3417
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Country | US
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Telephone | 610-522-5200
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Fax | 610-522-5202
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Provider Business Mailing Address
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Address Line | 637 MACDADE BLVD
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City | COLLINGDALE
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State | PA
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Zip | 19023-3417
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Country | US
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Telephone | 610-522-5200
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Fax | 610-522-5202
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JEAN-CLAUDE DJELHI YAHOT
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Credential |
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Telephone | 215-300-9371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482431
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License Number State | PA
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