PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #4 (NPI# 1164518866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164518866 |
| Entity Type | Organization |
| Organization Name | PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #4 |
| Other Organization Name | PHARMACY HEALTH CENTER #4 |
| Practice Address |
4400 Haverford Avenue Pharmacy Philadelphia PA 19104 |
| Mailing Address |
500 S. Broad Street Pharmacy/basement Philadelphia PA 19146 |
| Practice Telephone | 2156857926 |
| Mailing Telephone | 2156856864 |
| Mailing Fax Number | 2157901651 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | MR. JEFFREY T. PENDER (DIRECTOR OF PHARMACEUTICAL SERVICES) |
| Authorized Official Telephone | 2156856864 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP0905X |
Clinic/Center Specialization: Public Health, State or Local |
HP418324L | PA | Ambulatory Health Care Facilities |
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1000076950039 | 05 |
| Other Name | Type Code |
|---|---|
| Pharmacy Health Center #4 | Doing Business As Name - Organization |
| Street Address |
4400 HAVERFORD AVENUE PHARMACY |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154542843 | Janel Elizabeth Hackney | Internal Medicine | 4400 Haverford Avenue, Philadelphia, PA 19104 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093092447 | Philly Metro Pharmacy LLC | Pharmacy | 25 E Walnut Ln, Philadelphia, PA 19144-2002 | 2011-11-14 |
| 1619195104 | Jfk Medical Center Pharmacy | Pharmacy | 3001 Walnut St Fl 4, Philadelphia, PA 19104-3414 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437788551 | The Milton S Hershey Medical Center | Pharmacy | 2221 Noll Dr Rm B136, Lancaster, PA 17603-7614 | 2020-04-02 |
| 1235697418 | Option Care Infusion Suites, LLC. | Pharmacy | 825 Town Center Dr Ste 146&150, Langhorne, PA 19047-1753 | 2019-03-07 |
| 1902170186 | The Milton S. Hershey Medical Center | Pharmacy | 500 University Dr Suite 1200, Hershey, PA 17033-2360 | 2012-03-06 |
| 1326164138 | Penn State Uhs Pharmacy | Pharmacy | 202c Student Health Center, University Park, PA 16802-2129 | 2007-03-22 |
| 1356364210 | Pa University Hlth Svcs | Pharmacy | 130 Ritenour Building, University Park, PA 16802-7501 | 2006-07-25 |
| 1295755510 | University of Pittsburgh Office of The Conptroller | Pharmacy | 103 University Place, Pittsburgh, PA 15260 | 2006-07-20 |
| 1578175790 | Upmc East | Pharmacy | 2775 Mosside Blvd, Monroeville, PA 15146-2760 | 2020-08-19 |
| 1356800551 | Dwh Direct Rx LLC | Pharmacy | 524 W Broad St, Quakertown, PA 18951-1216 | 2019-03-18 |
| 1013475102 | Dwh Direct Rx LLC | Pharmacy | 1707-1709 W Hamilton Street, Allentown, PA 18036 | 2019-03-07 |
| 1639680317 | Grand View Urgent Care | Pharmacy | 700 Horizon Cir, Chalfont, PA 18914-3906 | 2017-10-20 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH CENTER PHARMACY #4.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.