Suburban Bustleton Pharmacy Inc.
Community/Retail Pharmacy
10875 Bustleton Avenue, Philadelphia
Pennsylvania, 19116-3301
215-673-0994 215-969-6176
Suburban Bustleton Pharmacy Inc. is a Community/Retail Pharmacy in Philadelphia, Pennsylvania. It is located at 10875 Bustleton Avenue, Philadelphia and it's customer support contact number is 215-673-0994. The authorized person of Suburban Bustleton Pharmacy Inc. is Ms. Jane Dzierza who is Owner of the pharmacy and her contact number is 215-673-0994. Active license number of Suburban Bustleton Pharmacy Inc. is PP412433L for Community/Retail Pharmacy in Pennsylvania. Suburban Bustleton Pharmacy Inc. accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Suburban Bustleton Pharmacy Inc. is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Suburban Bustleton Pharmacy Inc. type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Suburban Bustleton Pharmacy Inc. |
| Type: | Community/Retail Pharmacy |
| Location: | 10875 Bustleton Avenue, Philadelphia,
Pennsylvania, 19116-3301 |
| Phone: | 215-673-0994 |
| Fax: | 215-969-6176 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Jane Dzierza |
| Position: | Owner |
| Contact Number: | 215-673-0994 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1962560565 |
| NPI Enumeration Date: | 05 Dec, 2006 |
| NPI Last Update On: | 21 Jan, 2026 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Suburban Bustleton Pharmacy Inc. are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | PP412433L | Pennsylvania | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 0014348470001 | Medicaid | Pennsylvania | |
Medicare Enrollment:
Suburban Bustleton Pharmacy Inc. is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 6204955222 | O20120103000222 | Suburban Bustleton Pharmacy Inc. | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 10875 Bustleton Ave,
Philadelphia, Pennsylvania |
| Zip: | 19116-3301 |
| Phone Number: | 215-673-0994 |
| Fax Number: | 215-969-6176 |
Patients can reach Suburban Bustleton Pharmacy Inc. at
10875 Bustleton Avenue, Philadelphia, Pennsylvania or can
call on customer care at 215-673-0994.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 March, 2026.