Organization
MILLCREEK MANOR PHARMACY
Active
Other names
LECOM Senior Living Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME BABIAK (DIRECTOR OF PHARMACY)
(814) 868-3880
Entity
Organization
Contact information
Practice address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 868-3869
(814) 868-3405
Mailing address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 868-3869
(814) 868-3405
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PP482569
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151152
PK
—
Enumeration date
08/18/2015
Last updated
08/18/2015
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