Provider Demographics
NPI:1154640738
Name:SEBRELL, PHILLIP DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:DAVID
Last Name:SEBRELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 MASTERS DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3493
Mailing Address - Country:US
Mailing Address - Phone:215-715-8242
Mailing Address - Fax:
Practice Address - Street 1:180 UPLAND SQ DR
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:PA
Practice Address - Zip Code:19464-9432
Practice Address - Country:US
Practice Address - Phone:610-970-0004
Practice Address - Fax:610-970-0007
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-22
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist