Organization
THE SHEPHERDS HEALTH MART PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA HART (PROPRIETOR)
(917) 402-1685
Entity
Organization
Contact information
Practice address
415 DELAWARE AVE, PORTLAND, PA 18351
(570) 897-7437
(570) 897-2514
Mailing address
415 DELAWARE AVE, PORTLAND, PA 18351-0415
(570) 897-7437
(570) 897-2501
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP481605
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017998220001
—
PA
01
—
3987318
NABP/NCPDP
PA
01
—
3987318
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
02/08/2008
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