MEDICARE: MR. MONTANO RICHARD SANCHEZ RECINTO PHARMD

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
1	3336C0003X	Community/Retail Pharmacy	RP448562	PA

General Provider Information

NPI Number	:	1023613700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MONTANO RICHARD SANCHEZ RECINTO PHARMD

Provider Business Mailing Address
First Line	:	2132 SOUTH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1227
Country	:	US
Telephone Number	:	215-772-1260
Fax Number	:	215-772-1265

Provider Business Practice Location Address
First Line	:	2132 SOUTH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1227
Country	:	US
Telephone Number	:	215-772-1260
Fax Number	:	215-772-1265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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