Provider Demographics
NPI:1326257353
Name:COMPOUNDING RX APOTHECARY
Entity Type:Organization
Organization Name:COMPOUNDING RX APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:484-527-0203
Mailing Address - Street 1:81 LANCASTER AVE
Mailing Address - Street 2:STORE #4
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2139
Mailing Address - Country:US
Mailing Address - Phone:484-527-0203
Mailing Address - Fax:484-527-0205
Practice Address - Street 1:81 LANCASTER AVE
Practice Address - Street 2:STORE #4
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2139
Practice Address - Country:US
Practice Address - Phone:484-527-0203
Practice Address - Fax:484-527-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty