Tracemark Pharmacy

NPI 1215254305 - Pharmacy - 3336C0003X

NPI Details
NPI 1215254305
Enumeration Date 04/28/2010
Last Updated 04/28/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name BEVIS E BEVIS
Position PHARMACY OWNER
Phone (215) 324-0800
Fax (215) 324-0803
Practice Location
4839 N BROAD ST
PHILADELPHIA PA, 19141-2107, US
Phone (215) 324-0800
Fax (215) 324-0803
Business Location
4839 N BROAD ST
PHILADELPHIA PA, 19141-2107, US
Phone (215) 324-0800
Fax (215) 324-0803
Toxanomy
Taxonomy Code 3336C0003X
License State Pennsylvania
License Number PP481991
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According to our database, Tracemark Pharmacy NPI is 1215254305, taxonomy code is 3336C0003X and license number is PP481991, license state is located at Pennsylvania. Tracemark Pharmacy physically located at 4839 N Broad St, Philadelphia PA, 19141-2107. NPI Number 1033115704 has the healthcare provider type.

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1215254305 NPI number is provided on an as is basis without warranty of any kind. 1215254305 is maintained by the National Plan & Provider Enumeration System. The contents of Tracemark Pharmacy are for informational purposes only.