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General NPI Number Information
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NPI Number | 1154487502
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Entity Type | Individual
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Provider Name | ELOISE B GONZALES RPH
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | ONE PENN BLVD GERMANTOWN COMMUNITY HEALTH SERVICES PHARMACY
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City | PHILADELPHIA
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State | PA
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Zip | 19144
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Country | US
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Telephone | 215-951-8030
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Fax | 215-951-8083
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Provider Business Mailing Address
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Address Line | 2089 WELSH RD G 4
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City | PHILADELPHIA
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State | PA
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Zip | 19115
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Country | US
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Telephone | 215-951-8032
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Fax | 215-951-8083
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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 | RP027763L
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License Number State | PA
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