| NPI | 1104490143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOTAYO OLUFEMI BADEJOKO Pharmacy Manager/Owner 215-403-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-05-14 |