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General NPI Number Information
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NPI Number | 1104490143
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Entity Type | Organization
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Legal Business Name | HILLRISE PHARMACY LLC
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 4240 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-1908
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Country | US
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Telephone | 215-403-7300
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Fax | 267-335-3937
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Provider Business Mailing Address
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Address Line | 7817 CHELTENHAM AVE
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City | LAVEROCK
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State | PA
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Zip | 19038-7621
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Country | US
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Telephone | 484-326-1877
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Fax | 267-335-3937
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Authorized Official
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Title or Position | PHARMACY MANAGER/OWNER
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Name | OMOTAYO OLUFEMI BADEJOKO
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Credential |
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Telephone | 215-403-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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