| NPI | 1578835740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGDALIAH JACKSON Pharmacist/Owner 484-480-3341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA pp482215) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: PA pp482215) |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 183500000X Pharmacist | |
| 1835G0303X Pharmacist, Geriatric | |
| 1835N1003X Pharmacist, Nutrition Support | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-08-06 |