Provider Demographics
NPI:1255633319
Name:BLESSED PHARMACY
Entity type:Organization
Organization Name:BLESSED PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-380-9508
Mailing Address - Street 1:BLESSED PHARMACY
Mailing Address - Street 2:PO BOX 5642
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129
Mailing Address - Country:US
Mailing Address - Phone:215-765-2983
Mailing Address - Fax:215-765-2984
Practice Address - Street 1:2826 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1238
Practice Address - Country:US
Practice Address - Phone:215-765-2983
Practice Address - Fax:215-765-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP482074333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3994731OtherNCPDP PROVIDER IDENTIFICATION NUMBER