Organization
ROBERT PACKER HOSPITAL
Active
Other names
CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SHAY (OPERATIONS MANAGER)
(570) 887-2816
Entity
Organization
Contact information
Practice address
1 GUTHRIE SQ, SUITE EC101, SAYRE, PA 18840-1625
(570) 887-2800
(570) 887-2827
Mailing address
1 GUTHRIE SQ, SUITE EC101, SAYRE, PA 18840-1625
(570) 887-2800
(570) 887-2827
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP413232L
PA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007706140042
—
PA
01
—
1161970002
MEDICARE PTAN
PA
01
—
2082808
PK
—
Enumeration date
07/22/2006
Last updated
11/19/2015
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