Provider Demographics
NPI:1760624944
Name:PENN-PRESBYTERIAN APOTHECARY
Entity Type:Organization
Organization Name:PENN-PRESBYTERIAN APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OUTPATIENT PHARMACY
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RIBECCHI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-662-9496
Mailing Address - Street 1:3910 N POWELTON AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2640
Mailing Address - Country:US
Mailing Address - Phone:215-662-9496
Mailing Address - Fax:
Practice Address - Street 1:3910 POWELTON AVENUE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2692
Practice Address - Country:US
Practice Address - Phone:215-662-9496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PA HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4816403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy