MEDICARE: RYAN MCGURRIN RPH

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	PI122242	PA
2	183500000X	Pharmacist	RP457160	PA

General Provider Information

NPI Number	:	1508587700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN MCGURRIN RPH

Provider Business Mailing Address
First Line	:	1452 BETHLEHEM PIKE
Second Line	:
City	:	FLOURTOWN
State	:	PA
Zip	:	19031-2065
Country	:	US
Telephone Number	:	215-836-0128
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 JOHN F KENNEDY BLVD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1821
Country	:	US
Telephone Number	:	215-561-1316
Fax Number	:

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

Provider Enumeration Date	:	09/06/2022
Last Update Date	:	09/06/2022

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