| NPI | 1376643353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISSIE DIEM NGUYEN Pharmacy Manager 215-755-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: PA PP481360) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2009-05-01 |