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General NPI Number Information
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NPI Number | 1134528839
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Entity Type | Organization
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Legal Business Name | BUCKS PHILADELPHIA MEDICAL CARE GROUP
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 10745 HALDEMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3928
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Country | US
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Telephone | 215-947-6143
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Fax | 215-947-6274
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Provider Business Mailing Address
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Address Line | 10745 HALDEMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3928
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Country | US
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Telephone | 215-947-6143
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Fax | 215-947-6274
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | ANDREW BERKOWITZ
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Credential |
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Telephone | 215-947-6143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | MD036462-E
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License Number State | PA
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