Organization · Type 2 NPI

Penncare-J. Edwin Wood Clinic

Non-Pharmacy Dispensing Site · Philadelphia, PA

NPI number 1104967918 Active

Practice location

700 Spruce St, 304
Philadelphia, PA 19106-4022

Call (215) 829-3532 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

TaxonomyCodeLicense
Non-Pharmacy Dispensing Site Primary 332900000XOS012672 (PA)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

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About NPI 1104967918

Penncare-J. Edwin Wood Clinic's National Provider Identifier is 1104967918, issued on Feb 12, 2007. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Philadelphia, PA. The record was last updated on Dec 4, 2012.