MEDICARE: SUNBEAM CAMBRIA 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP411737L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2080607	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962485961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNBEAM CAMBRIA INC.

Provider Business Mailing Address
First Line	:	2860 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-2712
Country	:	US
Telephone Number	:	215-225-2886
Fax Number	:	215-227-0114

Provider Business Practice Location Address
First Line	:	2860 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-2712
Country	:	US
Telephone Number	:	215-225-2886
Fax Number	:	215-227-0114

Authorized Official
Title or Position	:	PRESIDENT/ PHARMACIST
Name	:	DHRUV PADODARA
Credential	:
Telephone Number	:	215-858-2062

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	08/15/2021

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