Provider Demographics
NPI:1952049769
Name:VRUSHO, DHIMO (PHARMD)
Entity Type:Individual
Prefix:
First Name:DHIMO
Middle Name:
Last Name:VRUSHO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 MARKET ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3368
Mailing Address - Country:US
Mailing Address - Phone:267-892-3107
Mailing Address - Fax:267-892-3108
Practice Address - Street 1:3550 MARKET ST STE 103
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3368
Practice Address - Country:US
Practice Address - Phone:267-892-3107
Practice Address - Fax:267-892-3108
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist