Company

52nd Street Pharmacy

Debarred entity

United States. Named in 2 sanctions listings.

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Summary

License number: PROMISe #102900899

Sanctions and listings2

  • Effective
    31 Mar 2017

    Official designation

    Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded

    pa.gov

  • Effective
    31 Mar 2017

    Official designation

    Pennsylvania Department of Human servicesUS Delaware Medicaid Sanctioned ProvidersUnited States

    Terminated Provider agreement due to no current certification or permit to practice as pharmacy in PA

    medicaid.dhss.delaware.gov

Connections1

Other links1

Identifiers3

IdentifierNumber
ID numberPP482438 /RPI002536
NPI number1306261169
Tax number463303782

Addresses1

  • Philadelphia, PA

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