| NPI | 1174629000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DAVID KERCHUSKY Pharmacy Manager 215-468-0622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP412990L) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2008-02-19 |