| NPI | 1669954210 |
|---|---|
| Doing Business As | LA VIDA DISCOUNT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | EDWARD OKEBIORUN President 215-427-1603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: PA PP482534) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2021-12-20 |