Angkor Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482423 Issued in PA

Legal business name

ANGKOR PHARMACY LLC

Doing business as

Angkor Pharmacy LLC

Practice address

2129-31 S. 7TH Street
Philadelphia, PA 19148

Phone

(267) 928-2600

Fax

(267) 928-2841

NPI assigned

Nov 5, 2013

Last updated

Sep 30, 2014By 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

Sean Ngo

Title

Owner

Phone

(215) 760-4214

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Angkor Pharmacy LLC Doing business as

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1366871741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129-31 S. 7TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "267-928-2600",
            "fax_number": "267-928-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129-31 S. 7TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "267-928-2600",
            "fax_number": "267-928-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGKOR PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-760-4214"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143403",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028841500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angkor Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angels of Love Home Care
• David Angelucci, DC
• Marjorie Angert, D.O.
• Margaret McGarrity Angevine, N.P.
• Tricia M. Angilletta, PSYD, LPC, ATR-BC
• Angela Caridad Angles, PA-C
• Anthony Angueira
• Valerie A Angulo
• John C. Anhalt, M.D.
• Omar Ani, MD

• 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 Sep 30, 2014; 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.