MEDICARE: BHS 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	3336C0003X	Community/Retail Pharmacy	PP481505	PA

General Provider Information

NPI Number	:	1285774646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHS PHARMACY INC

Provider Business Mailing Address
First Line	:	118 DIAMOND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-1720
Country	:	US
Telephone Number	:	215-763-7080
Fax Number	:	215-763-7515

Provider Business Practice Location Address
First Line	:	118 DIAMOND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-1415
Country	:	US
Telephone Number	:	215-763-7080
Fax Number	:	215-763-7515

Authorized Official
Title or Position	:	OWNERMANAGERPHARMACIST
Name	:	MRS. KATHLEEN DELPADRE GOLDBERG
Credential	:	RPH
Telephone Number	:	215-763-7080

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	05/16/2013

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