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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | SOMERTON PHARMACY · Somerton Pharmacy | [sources] | |||
| Other name | G&A Somerton Pharmcacy, LLC (dba) | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | OTHER BUSINESS · PHARMACY | [sources] | |||
| ID Number | PROMISe#
101195043 | [sources] | |||
| NPI | 1356419592 | [sources] | |||
| Registration number | G46PB29NLW95 | [sources] | |||
| Sector | 333600000X | [sources] | |||
| Tax Number | 201878091 | [sources] | |||
| Unique Entity ID | G46PB29NLW95 | [sources] | |||
| Address | 10806 BUSTLETON AVENUE, PHILADELPHIA, PA 19116 · 10806 BUSTLETON AVENUE, PHILADELPHIA, PA 19116, USA · Philadelphia, PA | [sources] | |||
| Last change | Last processed | First seen | |||
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People and companies excluded from Federally funded health care programs
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List of providers excluded from participating in the Delaware Medicaid program.
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us-medpa-3f740f299c3bb4a912206829e48abfe0c9514d62 · us-fed-excl-somerton-pharmacy-19116-philadelphia · us-medde-aff2d8a4d1498e10bbc4dba395aec429b86d241eFor experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| Philadelphia, PA | United States | |