MEDICARE: MEDPLUS 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

General Provider Information

NPI Number	:	1386346401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDPLUS PHARMACY INC

Provider Business Mailing Address
First Line	:	2410 RHAWN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3324
Country	:	US
Telephone Number	:	215-941-1220
Fax Number	:	215-904-7870

Provider Business Practice Location Address
First Line	:	2410 RHAWN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3324
Country	:	US
Telephone Number	:	215-941-1220
Fax Number	:	215-904-7870

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	VASILIOS PALENGAS
Credential	:
Telephone Number	:	215-941-1220

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/21/2023

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Directions to “MEDPLUS PHARMACY INC ” Practice Location

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