MEDICARE: ANGEL CARE PHARMACY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3336C0003X	Community/Retail Pharmacy
2	3336M0002X	Mail Order Pharmacy
3	3336S0011X	Specialty Pharmacy
4	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184238339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL CARE PHARMACY LLC

Provider Business Mailing Address
First Line	:	7223A RISING SUN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3926
Country	:	US
Telephone Number	:	610-708-3858
Fax Number	:	610-708-3859

Provider Business Practice Location Address
First Line	:	7223A RISING SUN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3926
Country	:	US
Telephone Number	:	610-708-3858
Fax Number	:	610-708-3859

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OLIVIA TCHANQUE
Credential	:	DOCTOR
Telephone Number	:	610-708-3858

Provider Enumeration Date	:	09/04/2020
Last Update Date	:	09/30/2024

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Directions to “ANGEL CARE PHARMACY LLC ” Practice Location

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