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Organization
KRESGE LEBAR PHARMACY
Active
Organization
KRESGE LEBAR PHARMACY
Active
Other names
Beta Property Enterprises, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTINS PRICKISIE (STORE MANAGER)
(570) 421-0710
Entity
Organization
Contact information
Practice address
425 MAIN ST, STROUDSBURG, PA 18360-2462
(570) 421-0710
(570) 421-3405
Mailing address
425 MAIN ST, STROUDSBURG, PA 18360-2462
(570) 421-0710
(570) 421-3405
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PP411345L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011208930001
—
PA
Enumeration date
07/14/2005
Last updated
08/22/2020
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