| NPI | 1811469760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BREESWINE Practice Administrator 215-345-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |