Philly Pharmacy II, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482144 Issued in PA

Legal business name

PHILLY PHARMACY II, LLC

Practice address

9475 Roosevelt Blvd Ste 12
Philadelphia, PA 19114-2212

Phone

(215) 625-6668

Fax

(866) 379-3198

NPI assigned

May 20, 2011

Organization subpart

No

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

Authorized official

Name

Edward Garcia

Title

Pharmacy Manager

Phone

(215) 969-5180

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Philly Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1972896173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 ROOSEVELT BLVD",
            "address_2": "STE 12",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142212",
            "telephone_number": "215-625-6668",
            "fax_number": "866-379-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 ROOSEVELT BLVD STE 12",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142212",
            "telephone_number": "215-625-6668",
            "fax_number": "866-379-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY PHARMACY II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-20",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "215-969-5180"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482144",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3995480",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philly 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 20, 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.