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General NPI Number Information
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NPI Number | 1699183871
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Entity Type | Organization
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Legal Business Name | JUST HERE III
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 7923A BUSTLETON AVE.
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City | PHILADELPHIA
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State | PA
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Zip | 19152
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Country | US
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Telephone | 215-821-3524
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Fax |
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Provider Business Mailing Address
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Address Line | 7923A BUSTLETON AVE.
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City | PHILADELPHIA
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State | PA
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Zip | 19152
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Country | US
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Telephone | 215-821-3524
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/CO-OWNER
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Name | DR. KWABENA ASAFO BOAKYE
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Credential | PHARM. D.
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Telephone | 267-250-3151
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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 | PP482414
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License Number State | PA
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