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General NPI Number Information
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NPI Number | 1699912501
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Entity Type | Organization
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Legal Business Name | PHILARX PHARMACY 1 INC
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 1742 SOUTH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19146
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Country | US
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Telephone | 267-324-5231
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Fax |
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Provider Business Mailing Address
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Address Line | 418 SOUTH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19147-1535
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Country | US
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Telephone | 215-880-7905
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Fax | 215-224-5416
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Authorized Official
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Title or Position | CEO
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Name | HAFIZ EBADY
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Credential |
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Telephone | 215-880-7905
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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 | PP481863
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License Number State | PA
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