| NPI | 1366817991 |
|---|---|
| Doing Business As | PENNSPORT MALL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GINO CUFFARI Manager/Owner 267-340-7534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA PP482611) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2018-07-19 |