Provider Demographics
NPI:1295474294
Name:PRECISION PHARMACY AND COMPOUNDING CENTER
Entity type:Organization
Organization Name:PRECISION PHARMACY AND COMPOUNDING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAMBANA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:240-472-8532
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-0282
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4110 BUTLER PIKE STE A100
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1547
Practice Address - Country:US
Practice Address - Phone:610-750-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP483078OtherPHARMACY LICENSE