Pharmacy Health Center #10

LBN: Philadelphia Department Of Public Health Center Pharmacy #10
Pharmacy Health Center #10 is an health care organization with primary practice located at 2230 Cottman Avenue , Philadelphia PA 19149. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Suppliers / Clinic Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Philadelphia Department Of Public Health Center Pharmacy #10 can be contacted via phone (215) 685-0616, or through Pender, Jeffrey T. via phone (215) 685-6864.

Contact Information

Primary practice address
2230 Cottman Avenue Philadelphia PA 19149
Phone: (215) 685-0616
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pender, Jeffrey T. RPH
Phone: (215) 685-6864

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X HP418337L Pennsylvania
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Pennsylvania
Suppliers / Clinic Pharmacy 3336C0002X

Profile Details

NPI number 1417038191
LBN Legal business name Philadelphia Department Of Public Health Center Pharmacy #10
DBA Doing business as Pharmacy Health Center #10
Authorized official Pender, Jeffrey T. RPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 18th, 2006
Last updated Mar 7th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417038191 NPPES
Pennsylvania MEDICAID 1000076950045

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