Provider Demographics
NPI:1063492296
Name:A & F PHARMACY
Entity Type:Organization
Organization Name:A & F PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:MATHEW
Authorized Official - Last Name:POLICARE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-425-5881
Mailing Address - Street 1:3200 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-3217
Mailing Address - Country:US
Mailing Address - Phone:215-425-5881
Mailing Address - Fax:215-425-5270
Practice Address - Street 1:3200 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-3217
Practice Address - Country:US
Practice Address - Phone:215-425-5881
Practice Address - Fax:215-425-5270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415774L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018425460001Medicaid
PAPP415774LOtherPHARMACY PERMIT
PA3978941OtherNCPDP
PA3978941OtherNCPDP
PA0018425460001Medicaid
PAPP415774LOtherPHARMACY PERMIT