Organization
TRI-VALLEY PHARMACY, INCORPORATED
Active
Other names
Tri-Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D. KLINE (PRESIDENT)
(570) 345-4966
Entity
Organization
Contact information
Practice address
101 S TULPEHOCKEN ST, PINE GROVE, PA 17963-1011
(570) 345-4966
Mailing address
101 S TULPEHOCKEN ST, PINE GROVE, PA 17963-1011
(570) 345-4966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PP415649L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007504240005
—
PA
Enumeration date
07/20/2005
Last updated
11/21/2012
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