Organization
FORTUNATO ENTERPRISES INC
Active
Other names
Squire Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON FORTUNATO (OWNER)
(610) 544-4645
Entity
Organization
Contact information
Practice address
1154 BALTIMORE PIKE, SPRINGFIELD, PA 19064-2850
(610) 544-4645
(610) 544-1757
Mailing address
1154 BALTIMORE PIKE, SPRINGFIELD, PA 19064-2850
(610) 544-4645
(610) 544-1757
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP413223L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007772120020
—
PA
01
—
3912688
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/07/2005
Last updated
10/20/2010
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