Provider Demographics
NPI:1467531715
Name:MORRISON PHARMACY, INC.
Entity Type:Organization
Organization Name:MORRISON PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRADSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-482-2697
Mailing Address - Street 1:6113 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1604
Mailing Address - Country:US
Mailing Address - Phone:215-482-2697
Mailing Address - Fax:215-482-8495
Practice Address - Street 1:6113 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1604
Practice Address - Country:US
Practice Address - Phone:215-482-2697
Practice Address - Fax:215-482-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP029940L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP411134LOtherPHARMACY STATE LICENSE
PAPP411134LOtherPHARMACY STATE LICENSE