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General NPI Number Information
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NPI Number | 1841296043
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Entity Type | Organization
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Legal Business Name | LANSDOWNE AVE PHARMACY
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5943 LANSDOWNE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19151-3932
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Country | US
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Telephone | 215-877-0700
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Fax | 215-877-4700
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Provider Business Mailing Address
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Address Line | 5943 LANSDOWNE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19151-3932
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Country | US
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Telephone | 215-877-0700
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Fax | 215-877-4700
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUSAN C FORBES
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Credential |
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Telephone | 215-877-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP481416
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License Number State | PA
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