Broad Street Family Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PP4811922 Issued in PA

Legal business name

BROAD STREET FAMILY PHARMACY

Practice address

1416 S Broad St
Philadelphia, PA 19146-4861

Phone

(215) 755-2010

NPI assigned

Aug 5, 2009

Organization subpart

No

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

Authorized official

Name

Elizabeth Thompson

Title

President

Phone

(215) 755-2010

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1497986657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464861",
            "telephone_number": "215-755-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464861",
            "telephone_number": "215-755-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD STREET FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-755-2010"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP4811922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PP481922",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broad and Snyder Pharmacy P C
• Broad Health Center Inc.
• Broad St Pharmacy
• Broad Street Braces
• Broad Street Chiropractic & Wellness Center, LLC
• Broad Street Medical LLC
• Broad Street Professional Medical Services LLC
• Broad Wellness and Chiropractic Center, P.C.
• Louis T Broad, MD
• Michael Broadbent, COTA/L

• Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.