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Organization
WILKES-BARRE BEHAVIORAL HOSPITAL COMPANY LLC
Active
Organization
WILKES-BARRE BEHAVIORAL HOSPITAL COMPANY LLC
Active
Other names
General Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
562 WYOMING AVE, KINGSTON, PA 18704-3721
(570) 552-7500
(570) 552-7520
Mailing address
562 WYOMING AVE, KINGSTON, PA 18704-3721
(570) 552-7500
(570) 552-7520
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336I0012X
Institutional Pharmacy
PP413699L
PA
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022885770017
—
PA
01
—
2085164
PK
—
Enumeration date
11/16/2005
Last updated
04/26/2021
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