Provider Demographics
NPI:1801879010
Name:CAMBRIA PHARMACIES INC
Entity type:Organization
Organization Name:CAMBRIA PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-425-6869
Mailing Address - Street 1:2900 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-1832
Mailing Address - Country:US
Mailing Address - Phone:215-229-6454
Mailing Address - Fax:229-229-2508
Practice Address - Street 1:2900 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-1832
Practice Address - Country:US
Practice Address - Phone:215-229-6454
Practice Address - Fax:229-229-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP411736L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007472960003Medicaid
PA00572052Medicaid
2080606OtherPK
PA1007472960003Medicaid