MEDICARE: CHELTEN AVENUE PHARMACY 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
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1083445522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHELTEN AVENUE PHARMACY INC

Provider Business Mailing Address
First Line	:	2137 E CHELTEN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-2534
Country	:	US
Telephone Number	:	267-766-6713
Fax Number	:	267-766-6725

Provider Business Practice Location Address
First Line	:	2137 E CHELTEN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-2534
Country	:	US
Telephone Number	:	267-766-6713
Fax Number	:	267-766-6725

Authorized Official
Title or Position	:	PRESIDENT
Name	:	UMESH PATEL
Credential	:
Telephone Number	:	443-370-6964

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	08/07/2024

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