MEDICARE: CHRISTIAN ST PHARMACY

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	333600000X	Pharmacy	PP412075L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3948203	OTHER	PA	NABP

General Provider Information

NPI Number	:	1558587030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN ST PHARMACY

Provider Business Mailing Address
First Line	:	1947 CHRISTIAN STREET
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146
Country	:	US
Telephone Number	:	215-545-3582
Fax Number	:	215-545-3583

Provider Business Practice Location Address
First Line	:	1947 CHRISTIAN STREET
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146
Country	:	US
Telephone Number	:	215-545-3582
Fax Number	:	215-545-3583

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. JEROME P WHACK
Credential	:	RPH
Telephone Number	:	215-545-3582

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1891645479 — MR. ZEV MICHAEL KRAMER LSW
Practice Location Address:

1002 S DORRANCE ST
PHILADELPHIA, PA
19146-2651

Practice Phone: 267-670-1948
Practice Fax:

1780534214 — THE REPRODUCTIVE WELLNESS CENTER
Practice Location Address:

1237 S 20TH ST
PHILADELPHIA, PA
19146-2947

Practice Phone: 215-901-3712
Practice Fax:

1982555777 — SARAH EBBS
Practice Location Address:

1701 FEDERAL ST APT 203
PHILADELPHIA, PA
19146-3075

Practice Phone: 617-935-3525
Practice Fax:

1619843539 — GRAYS EYE CARE LLC
Practice Location Address:

2893 GRAYS FERRY AVE
PHILADELPHIA, PA
19146-2708

Practice Phone: 215-964-9605
Practice Fax:

1750385449 — ELIOT M WALLACK MD
Practice Location Address:

1840 SOUTH ST , TUTTLEMAN BUILDING
PHILADELPHIA, PA
19146-7411

Practice Phone: 215-893-6200
Practice Fax:

1720085244 — DIAN LAU MD
Practice Location Address:

520 S 19TH ST , STE 1B
PHILADELPHIA, PA
19146-1449

Practice Phone: 215-545-4173
Practice Fax: 215-545-1543

1629075148 — ALLEN JAY SCHWALB MD
Practice Location Address:

520 S 19TH ST , STE 1B
PHILADELPHIA, PA
19146-1449

Practice Phone: 215-545-4173
Practice Fax: 215-545-1543

Directions to “CHRISTIAN ST PHARMACY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.