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NPI Code Detail

MEDICARE: LENNY FOX

MEDICARE:   LENNY  FOX
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
1183500000XPharmacistRP439481PA

General Provider Information

NPI Number : 1629601943
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENNY FOX
Provider Business Mailing Address
First Line : 10875 BUSTLETON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-3301
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10875 BUSTLETON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-3301
Country : US
Telephone Number : 215-673-0994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2020
Last Update Date : 02/14/2020

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Directions to “ LENNY FOX ” Practice Location

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