MEDICARE: MARLENE OCHABILLO

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	183500000X	Pharmacist	RP-040148L	PA

General Provider Information

NPI Number	:	1265023600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENE OCHABILLO

Provider Business Mailing Address
First Line	:	6150 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-1423
Country	:	US
Telephone Number	:	215-548-1110
Fax Number	:	215-224-1100

Provider Business Practice Location Address
First Line	:	6150 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-1423
Country	:	US
Telephone Number	:	215-548-1110
Fax Number	:	215-224-1100

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

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	01/28/2021

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Directions to “ MARLENE OCHABILLO ” Practice Location

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