Provider Demographics
NPI:1962627810
Name:MESSIAH PHARMARCY
Entity Type:Organization
Organization Name:MESSIAH PHARMARCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ONU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-232-1021
Mailing Address - Street 1:PO BOX 38145
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-0145
Mailing Address - Country:US
Mailing Address - Phone:215-232-1021
Mailing Address - Fax:215-232-1023
Practice Address - Street 1:2445 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-3013
Practice Address - Country:US
Practice Address - Phone:215-232-1021
Practice Address - Fax:215-232-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415350L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty