| NPI | 1588079909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY GANNON Pharmacy Manager 724-443-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp045848l) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp1003968) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |