Sdarbouze Apothecary Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

SDARBOUZE APOTHECARY INC.

Practice address

5751 N Broad St Ste 3
Philadelphia, PA 19141-2302

Phone

(215) 424-2611

NPI assigned

Oct 7, 2019

Organization subpart

No

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

Authorized official

Name

John D Ivey Jr.

Title

Owner

Phone

(215) 424-2611

Specialties & licenses 1

Addresses

Other names 1

• Broad & Amp; Grange Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wiltherkeen Auguste, PHARMACIST

  • Pharmacist
  • Philadelphia, PA
  • NPI 1053028522
  NPD

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1609417070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 N BROAD ST STE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412302",
            "telephone_number": "215-424-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 N BROAD ST STE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412302",
            "telephone_number": "215-424-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDARBOUZE APOTHECARY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-424-2611",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad & Amp; Grange Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Sue Sculley, MS, CGC
• Sara Sculley
• Scutt Home Care Agency L.L.C
• Amanda Marie Sczymecki, LCSW
• Taylor Sczymecki
• Allison Seabrease
• Deborah Seagull, PH.D.
• Lauren Sealy
• Seamless Living Solutions LLC
• Mark John Seamon, MD

• 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 Oct 7, 2019; 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.