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General NPI Number Information
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NPI Number | 1356371587
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Entity Type | Organization
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Legal Business Name | MEDICAL TOWER PHARMACY INC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 255 S 17TH ST GROUND FLOOR
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City | PHILA
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State | PA
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Zip | 19103-6231
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Country | US
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Telephone | 215-545-3525
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Fax | 215-732-7013
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Provider Business Mailing Address
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Address Line | 255 S 17TH ST GROUND FLOOR
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City | PHILA
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State | PA
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Zip | 19103-6231
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Country | US
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Telephone | 215-545-3525
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Fax | 215-732-7013
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Authorized Official
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Title or Position | PHARMACIST MANAGER
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Name | MR. DANIEL B HELLER
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Credential | RPH
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Telephone | 215-545-3525
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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 | PP410793L
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License Number State | PA
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