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General NPI Number Information
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NPI Number | 1710183835
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Entity Type | Organization
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Legal Business Name | AMIGOS PHARMACY INC.
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 3027 KENSINGTON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-2415
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Country | US
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Telephone | 215-426-0250
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Fax | 215-426-0253
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Provider Business Mailing Address
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Address Line | 107 PINE CONE CT
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-3713
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Country | US
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Telephone | 856-725-2463
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Fax |
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | DR. PAUL DELGADO
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Credential |
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Telephone | 856-725-2463
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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 | PP481701
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License Number State | PA
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