MEDICARE: JOMICI APOTHECARY LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1336070424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOMICI APOTHECARY LLC

Provider Business Mailing Address
First Line	:	273 S 15TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-5060
Country	:	US
Telephone Number	:	215-735-6337
Fax Number	:	215-790-0355

Provider Business Practice Location Address
First Line	:	273 S 15TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-5060
Country	:	US
Telephone Number	:	215-735-6337
Fax Number	:	215-790-0355

Authorized Official
Title or Position	:	PIC/MEMBER
Name	:	NOEL ABRAHAM
Credential	:
Telephone Number	:	215-735-6337

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “JOMICI APOTHECARY LLC ” Practice Location

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