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General NPI Number Information
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NPI Number | 1205032174
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Entity Type | Organization
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Legal Business Name | JUDY SEYEDROUDBARI
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2250 HICKORY RD STE 240
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1047
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Country | US
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Telephone | 610-834-1122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 106
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City | UWCHLAND
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State | PA
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Zip | 19480-0106
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Country | US
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Telephone | 484-889-9783
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUDY SEYEDROUDBARI
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Credential |
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Telephone | 484-889-9783
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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 | RP440855
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License Number State | PA
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