Provider Demographics
NPI:1881906154
Name:POSPOLYTA, BASIL W (RPH)
Entity type:Individual
Prefix:MR
First Name:BASIL
Middle Name:W
Last Name:POSPOLYTA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3127
Mailing Address - Country:US
Mailing Address - Phone:856-429-5197
Mailing Address - Fax:
Practice Address - Street 1:522 S 2ND ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19147-2409
Practice Address - Country:US
Practice Address - Phone:215-625-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038421L183500000X
NJ28RI03095300183500000X
FLPS30803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist