Philly Metro Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482159 Issued in PA

Legal business name

PHILLY METRO PHARMACY LLC

Doing business as

philly metro pharmacy

Practice address

25 E Walnut LN
Philadelphia, PA 19144-2002

Phone

(267) 331-5626

Fax

(267) 331-5743

NPI assigned

Nov 14, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Israel Ogunleye

Title

Owner

Phone

(267) 331-5626

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• philly metro pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1093092447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WALNUT LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442002",
            "telephone_number": "267-331-5626",
            "fax_number": "267-331-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WALNUT LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442002",
            "telephone_number": "267-331-5626",
            "fax_number": "267-331-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY METRO PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "OGUNLEYE",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-331-5626"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3996696",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "philly metro pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.