Organization
BLOSS PHARMACY, INC.
Active
Other names
Bloss Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MCTISH PHARMD (OWNER)
(570) 638-2820
Entity
Organization
Contact information
Practice address
2 RIVERSIDE PLAZA, BLOSSBURG, PA 16912-1137
(570) 638-2820
(570) 638-3642
Mailing address
2 RIVERSIDE PLAZA, BLOSSBURG, PA 16912-1137
(570) 638-2820
(570) 638-3642
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP411873L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102574237
—
PA
01
—
2128878
PK
—
Enumeration date
06/13/2005
Last updated
11/03/2020
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