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Organization

VINE PHARMACY

Active
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Organization

VINE PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLOTTE K MOSS PHARMD (OWNER)
(570) 925-2500
Entity
Organization

Contact information

Practice address
4375 RED ROCK RD, BENTON, PA 17814-7948
(570) 925-2500
(570) 925-5771
Mailing address
4375 RED ROCK RD, BENTON, PA 17814-7948
(570) 925-2500
(570) 925-5771

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Enumeration date
05/26/2022
Last updated
05/26/2022
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