Provider Demographics
NPI:1316179211
Name:EMACARE PHARMACY
Entity type:Organization
Organization Name:EMACARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELTAYEB
Authorized Official - Middle Name:B
Authorized Official - Last Name:ELHASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-850-3031
Mailing Address - Street 1:2718 WILLITS RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1646
Mailing Address - Country:US
Mailing Address - Phone:215-850-3031
Mailing Address - Fax:215-745-0808
Practice Address - Street 1:2718 WILLITS RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1646
Practice Address - Country:US
Practice Address - Phone:215-850-3031
Practice Address - Fax:215-745-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4414161835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherPHARMACY