# EVOLUTION PHARMACY SERVICE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** evolution pharmacy service inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750699179
- **Authorized official:** JEROME SAUTER RPH (PRESIDENT)
- **Authorized official phone:** (570) 534-0995

## Contact information

- **Practice address:** 401 LAUREL ST, PITTSTON, PA 18640-3557
- **Practice address phone:** (570) 534-0995
- **Practice address fax:** (570) 299-7896
- **Mailing address:** 401 LAUREL ST, PITTSTON, PA 18640-3557
- **Mailing address phone:** (570) 534-0995
- **Mailing address fax:** (570) 299-7896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PP482045 | PA | Yes |

## Other

- **Enumeration date:** 09/20/2010
- **Last updated:** 01/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2126766 | PK | — |