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General NPI Number Information
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NPI Number | 1992141030
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Entity Type | Organization
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Legal Business Name | INDEPENDENT RX INCORPORATED
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 843 S 2ND ST STE 2
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City | PHILADELPHIA
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State | PA
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Zip | 19147-3445
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Country | US
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Telephone | 267-324-5347
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Fax | 267-324-5418
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Provider Business Mailing Address
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Address Line | 2660 LEFEVRE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19137-2044
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Country | US
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Telephone | 215-535-4111
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Fax | 215-535-4115
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JOSEPH DYMOWSKI
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Credential |
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Telephone | 267-324-5347
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482369
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License Number State | PA
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