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General NPI Number Information
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NPI Number | 1447632427
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Entity Type | Organization
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Legal Business Name | RIDGE DISCOUNT PHARMACY LLC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 1406A RIDGE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19130-2914
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Country | US
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Telephone | 267-519-3387
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Fax | 267-519-3429
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Provider Business Mailing Address
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Address Line | 1406A RIDGE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19130-2914
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Country | US
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Telephone | 267-519-3387
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Fax | 267-519-3429
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROCCO DIMATTIA
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Credential |
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Telephone | 267-519-3387
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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 | PP482564
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License Number State | PA
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