National Provider Identifier Database

PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY 10
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #10
2230 COTTMAN AVENUE
PHILADELPHIA, PA19149
Phone: 215-685-0616
Fax:
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X
Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #10

NPI Number 1417038191
Legal business name
LBN
PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #10
Authorized official JEFFREY PENDER - (DIRECTOR OF PHARMACEUTICAL SERVICES)
Entity Organization
Organization subpart Yes
Enumeration date 10/18/2006
Last updated 03/07/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: HP418337L
  • PA Medicaid: 1000076950045

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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