| NPI | 1700082773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ZOREK Manager Online Adjudication 717-975-5937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 028499) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2011-10-07 |