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General NPI Number Information
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NPI Number | 1326257353
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Entity Type | Organization
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Legal Business Name | COMPOUNDING RX APOTHECARY
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 81 LANCASTER AVE STORE #4
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City | MALVERN
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State | PA
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Zip | 19355-2139
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Country | US
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Telephone | 484-527-0203
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Fax | 484-527-0205
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Provider Business Mailing Address
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Address Line | 81 LANCASTER AVE STORE #4
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City | MALVERN
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State | PA
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Zip | 19355-2139
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Country | US
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Telephone | 484-527-0203
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Fax | 484-527-0205
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. ERIC FOX
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Credential | RPH
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Telephone | 484-527-0203
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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 | PP481331
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License Number State | PA
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