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General NPI Number Information
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NPI Number | 1194355172
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Entity Type | Organization
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Legal Business Name | WYOMING PHARMACY LLC
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Dates
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Enumeration Date | 01/18/2020
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Last Update Date | 01/18/2020
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Provider Practice Location Address
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Address Line | 333 E WYOMING AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4434
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Country | US
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Telephone | 215-333-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 333 E WYOMING AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4434
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Country | US
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Telephone | 215-333-1555
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. SAIFUL ISLAM
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Credential | PHARMACIST
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Telephone | 407-967-6840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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