E-Glam Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481822 Issued in PA

Legal business name

E-GLAM INC

Doing business as

E-Glam Pharmacy

Practice address

746 E Chelten Ave
Philadelphia, PA 19144-1207

Phone

(215) 849-4272

Fax

(267) 331-8641

NPI assigned

Oct 10, 2008

Last updated

Jan 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Inyang Inyang

Title

Owner

Phone

(215) 849-4272

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• E-Glam Pharmacy Doing business as

Tax ID family

E-Glam Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• E-Glam Inc

  dba e-glam pharmacy II

  • Pharmacy
  • Philadelphia, PA
  • NPI 1477864924
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• E-Glam Inc

  dba e-glam pharmacy II

  • Pharmacy
  • Philadelphia, PA
  • NPI 1477864924
  NPPES parent name

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1164673943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 E CHELTEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441207",
            "telephone_number": "215-849-4272",
            "fax_number": "267-331-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 E CHELTEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441207",
            "telephone_number": "215-849-4272",
            "fax_number": "267-331-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E-GLAM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "INYANG",
        "authorized_official_first_name": "INYANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-849-4272"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022445180001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2117398",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "E-Glam Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noah Dzuba, MSW, ASW
• David John Dzurinko, MD
• Jessica Marie Dzurinko
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• E&K Behavioral and Community Supports LLC

• 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 Jan 28, 2016; 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.