=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376695510
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RXD HEALTHCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2007
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1335 W TABOR RD SUITE 103
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19141-3038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-927-7935
-----------------------------------------------------
Fax | 215-924-0960
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 428 724 HADDON
-----------------------------------------------------
City | COLLINGSWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08108-0428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-858-9292
-----------------------------------------------------
Fax | 856-858-7286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | MR. CRAIG E LEHRMAN
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 215-927-6700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number | PP481328
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------