Provider Demographics
NPI:1356630875
Name:TOPICAL APOTHECARY GROUP
Entity Type:Organization
Organization Name:TOPICAL APOTHECARY GROUP
Other - Org Name:TAG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-888-7619
Mailing Address - Street 1:780 PRIMOS AVE STE E
Mailing Address - Street 2:
Mailing Address - City:FOLCROFT
Mailing Address - State:PA
Mailing Address - Zip Code:19032-2000
Mailing Address - Country:US
Mailing Address - Phone:484-477-0700
Mailing Address - Fax:610-522-9006
Practice Address - Street 1:780 PRIMOS AVE STE E
Practice Address - Street 2:
Practice Address - City:FOLCROFT
Practice Address - State:PA
Practice Address - Zip Code:19032-2000
Practice Address - Country:US
Practice Address - Phone:484-477-0700
Practice Address - Fax:610-522-9006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4821533336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129973OtherPK