| NPI Details | |
|---|---|
| NPI | 1700186004 |
| Enumeration Date | 11/02/2010 |
| Last Updated | 11/02/2010 |
| Entity Type | Healthcare Provider |
| Active | Over 6 years ago |
| Authorized Information | |
|---|---|
| Name | CHARLES KWAME CHARLES |
| Position | PHARMACY MANAGER |
| Phone | (215) 365-1088 |
| Fax | (215) 365-1699 |
| Practice Location | |
|---|---|
| 7028 ELMWOOD AVE PHILADELPHIA PA, 19142-1722, US |
|
| Phone | (215) 365-1088 |
| Fax | (215) 365-1699 |
| Business Location | |
|---|---|
| 7028 ELMWOOD AVE PHILADELPHIA PA, 19142-1722, US |
|
| Phone | (215) 365-1088 |
| Fax | (215) 365-1699 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 3336C0003X |
| License State | Pennsylvania |
| License Number | PP482087 |
| Remove 1700186004 NPI Number | |
According to our database, Four Star Pharmacy NPI is 1700186004, taxonomy code is 3336C0003X and license number is PP482087, license state is located at Pennsylvania. Four Star Pharmacy physically located at 7028 Elmwood Ave, Philadelphia PA, 19142-1722. NPI Number 1033115704 has the healthcare provider type.
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1700186004 NPI number is provided on an as is basis without warranty of any kind. 1700186004 is maintained by the National Plan & Provider Enumeration System. The contents of Four Star Pharmacy are for informational purposes only.
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