Organization
EAST SHORE PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MUBBALA RPH (OWNER)
(717) 213-3708
Entity
Organization
Contact information
Practice address
2723 AGATE ST, HARRISBURG, PA 17110-2645
(717) 213-3708
(717) 213-0095
Mailing address
2723 AGATE ST, HARRISBURG, PA 17110-2645
(717) 213-3708
(717) 213-0956
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481584
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017526390001
—
PA
01
—
2088014
PK
—
Enumeration date
08/02/2006
Last updated
12/11/2017
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