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NPI Code Detail

MEDICARE: MARYAM PHARMACY GROUP,INC

MEDICARE: MARYAM PHARMACY GROUP,INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyPP482348PA

General Provider Information

NPI Number : 1023356599
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARYAM PHARMACY GROUP,INC
Provider Business Mailing Address
First Line : 7339 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19136-3929
Country : US
Telephone Number : 267-809-2396
Fax Number : 215-331-2122
Provider Business Practice Location Address
First Line : 7339 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19136-3929
Country : US
Telephone Number : 267-809-2396
Fax Number : 215-331-2122
Authorized Official
Title or Position : PRESIDENT
Name : MR. SYED RAZA HASAN
Credential : RPH
Telephone Number : 267-809-2396
Provider Enumeration Date : 01/17/2013
Last Update Date : 01/17/2013

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Directions to “MARYAM PHARMACY GROUP,INC ” Practice Location

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