Provider Demographics
NPI:1609565779
Name:ATTERBURY, ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ATTERBURY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:ATTERBURY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:713 S 9TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2005
Mailing Address - Country:US
Mailing Address - Phone:614-202-2163
Mailing Address - Fax:
Practice Address - Street 1:601 S 10TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1917
Practice Address - Country:US
Practice Address - Phone:267-635-4576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist