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General NPI Number Information
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NPI Number | 1013718030
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Entity Type | Individual
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Provider Name | SAM ELIAS RPH
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Gender | Male
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 317 W LANCASTER AVE
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City | ARDMORE
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State | PA
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Zip | 19003-1403
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Country | US
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Telephone | 610-658-0737
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Fax |
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Provider Business Mailing Address
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Address Line | 454 DELMAR STRTEET
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City | PHILADELPHIA
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State | PA
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Zip | 19128
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Country | US
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Telephone | 267-225-0828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | RP459102
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License Number State | PA
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