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General NPI Number Information
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NPI Number | 1184186470
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Entity Type | Organization
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Legal Business Name | COTTMAN 1 PHARMACY LLC
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 1701 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-3802
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Country | US
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Telephone | 215-728-6300
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Fax | 215-728-6302
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Provider Business Mailing Address
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Address Line | 1701 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-3802
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Country | US
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Telephone | 215-728-6300
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Fax | 215-728-6302
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Authorized Official
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Title or Position | MEMBER OF LLC
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Name | NIKITA PATEL
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Credential |
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Telephone | 215-728-6300
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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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