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General NPI Number Information
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NPI Number | 1568580603
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Entity Type | Organization
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Legal Business Name | I & L EXPRESS PHARMACY LLC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 9977 BUSTLETON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19115-1557
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Country | US
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Telephone | 215-677-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 9977 BUSTLETON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19115-1557
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | IRINA MINKOVICH
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Credential | RPH
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Telephone | 215-677-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP481381
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License Number State | PA
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