Provider Demographics
NPI:1588397632
Name:DELAWARE VALLEY PHARMACY LLC
Entity type:Organization
Organization Name:DELAWARE VALLEY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:IGBOKIDI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:215-730-6528
Mailing Address - Street 1:200 SOUTHWYK RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8851
Mailing Address - Country:US
Mailing Address - Phone:215-203-2238
Mailing Address - Fax:
Practice Address - Street 1:2247 S 71ST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1130
Practice Address - Country:US
Practice Address - Phone:215-730-6528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy