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General NPI Number Information
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NPI Number | 1770236044
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Entity Type | Organization
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Legal Business Name | TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 625 CLARK AVE STE 10
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4025
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Country | US
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Telephone | 610-992-3920
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Fax |
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Provider Business Mailing Address
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Address Line | 625 CLARK AVE STE 10
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4025
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Country | US
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Telephone | 610-992-3920
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR OF PHARMACY
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Name | GENEVIEVE LEVANS
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Credential |
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Telephone | 215-796-2085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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