| Pharmacy Health Center #4 | |
|
4400 Haverford Avenue Pharmacy Philadelphia PA 19104 | |
| (215) 685-7926 | |
| Not Available |
| Full Name | Pharmacy Health Center #4 |
|---|---|
| Speciality | Pharmacy - Clinic Pharmacy |
| Location | 4400 Haverford Avenue, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Jeffrey T. Pender (DIRECTOR OF PHARMACEUTICAL SERVICES) |
| Authorized Official Contact | 2156856864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pharmacy Health Center #4 500 S. Broad Street Pharmacy/basement Philadelphia PA 19146 Ph: (215) 685-6864 | Pharmacy Health Center #4 4400 Haverford Avenue Pharmacy Philadelphia PA 19104 Ph: (215) 685-7926 |
| NPI Number | 1164518866 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 03/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164518866 | NPI | - | NPPES |
| 1000076950039 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | HP418324L (Pennsylvania) | Secondary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | (* (Not Available)) | Primary |
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