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Organization
MILLCREEK MANOR PHARMACY
Active
Organization
MILLCREEK MANOR PHARMACY
Active
Other names
LECOM Senior Living Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME BABIAK (DIRECTOR OF PHARMACY)
(814) 868-3880
Entity
Organization
Contact information
Practice address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 868-3869
(814) 868-3405
Mailing address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 868-3869
(814) 868-3405
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
PP482569
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151152
PK
—
Enumeration date
08/18/2015
Last updated
08/18/2015
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