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General NPI Number Information
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NPI Number | 1629470794
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Entity Type | Organization
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Legal Business Name | SUNIL PHARMACY IV INC.
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Dates
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Enumeration Date | 09/20/2014
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Last Update Date | 09/20/2014
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Provider Practice Location Address
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Address Line | 134 S 11TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4931
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Country | US
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Telephone | 215-238-0002
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Fax | 215-238-0004
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Provider Business Mailing Address
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Address Line | 1207 N 5TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19122-4301
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Country | US
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Telephone | 215-235-3245
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Fax | 215-232-2859
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Authorized Official
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Title or Position | OWNER
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Name | MR. SUBHASH B PATEL
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Credential | R.PH
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Telephone | 215-603-8288
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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 | PP482509
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License Number State | PA
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