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Organization

CRESTWOOD PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES ANTHONY HANLON RPH. (PARTNER, PHARMACIST)
(570) 474-5859
Entity
Organization

Contact information

Practice address
10 S MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1123
(570) 474-5859
(570) 474-9594
Mailing address
10 S MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1123
(570) 474-5859
(570) 474-9594

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP410503L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000704536
PA
Enumeration date
11/13/2006
Last updated
07/07/2008
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