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NPI Code Detail

MEDICARE: KRUPA DAVE PHARMD

MEDICARE: KRUPA DAVE 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
1183500000XPharmacistRP446784PA

General Provider Information

NPI Number : 1215371109
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRUPA DAVE PHARMD
Provider Business Mailing Address
First Line : 6101 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-1931
Country : US
Telephone Number : 215-924-9645
Fax Number :
Provider Business Practice Location Address
First Line : 6101 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-1931
Country : US
Telephone Number : 215-924-9645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2013
Last Update Date : 04/22/2013

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Directions to “ KRUPA DAVE PHARMD” Practice Location

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