| NPI | 1275566523 |
|---|---|
| Doing Business As | SUPER G PHARMACY 386 |
| Entity Type | Organization |
| Authorized Contact | ALISON FARRELL Director, Pharmacy Third Party 717-240-1526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: DE A30000593) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: DE A30000593) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DE A30000593) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2013-10-04 |