=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275872285
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTH PLUS PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2013
-----------------------------------------------------
Last Update Date | 02/11/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8441 W CHESTER PIKE
-----------------------------------------------------
City | UPPER DARBY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19082-1104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-446-4900
-----------------------------------------------------
Fax | 610-446-4911
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8441 W CHESTER PIKE
-----------------------------------------------------
City | UPPER DARBY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19082-1104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-446-4900
-----------------------------------------------------
Fax | 610-446-4911
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. CHRISTOPHER RAYMOND HOFFMAN
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 610-446-4900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PP482323
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------