| NPI | 1619056389 |
|---|---|
| Doing Business As | BROAD STREET APOTHECARY |
| Entity Type | Organization |
| Authorized Contact | PAUL TIROTTO President 215-551-9485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA PP414268L) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-02-22 |