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Contact Information

PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #1
500 S. BROAD STREET
PHARMACY
PHILADELPHIA, PA19146
 Phone: 215-685-6513
 Fax: 215-790-1651
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #1

NPI # 1780752188
LBN Legal business name PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #1
Authorized official JEFFREY PENDER - (DIRECTOR OF PHARMACEUTICAL SERVICES)
Entity Organization
Organization subpart 1 No
Enumeration date 12/01/2006
Last updated 03/07/2019 - About 7 years ago
Identifiers
PA License # PP481593
PA Medicaid 1000076950093
Other 2081751 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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