| NPI | 1104206382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGDALIAH JACKSON President 610-333-0131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP482558) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2020-01-02 |