# DEPARTMENT OF MILITARY AFFAIRS COMMONWEALTH OF PENNSYLVANIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gino Merli Veterans' Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104181189
- **Authorized official:** THOMAS REED JR. (FISCAL SERVICES ADMINISTRATOR)
- **Authorized official phone:** (814) 242-7789

## Contact information

- **Practice address:** 401 PENN AVE, SCRANTON, PA 18503-1213
- **Practice address phone:** (570) 961-4300
- **Mailing address:** 401 PENN AVE, SCRANTON, PA 18503-1213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | HP418379L | PA | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/06/2012
- **Last updated:** 05/24/2022