MEDICARE: OSAMA ELWIR

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	RP446808	PA

General Provider Information

NPI Number	:	1902491913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAMA ELWIR

Provider Business Mailing Address
First Line	:	20 TAVERN LN
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-5693
Country	:	US
Telephone Number	:	714-599-3250
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 CASTOR AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-4026
Country	:	US
Telephone Number	:	215-722-6200
Fax Number	:

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

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/02/2021

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Directions to “ OSAMA ELWIR ” Practice Location

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