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General NPI Number Information
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NPI Number | 1619195104
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Entity Type | Organization
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Legal Business Name | JFK MEDICAL CENTER PHARMACY
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 3001 WALNUT ST FL 4
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3414
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Country | US
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Telephone | 215-386-4708
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 WALNUT ST FL 4
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3414
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Country | US
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Telephone | 215-386-4708
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | CHERIAN ABRAHAM
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Credential | R.PH.
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Telephone | 215-386-4708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PP418375L
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License Number State | PA
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