Organization
JOHN R SLAGLE
Active
Other names
waterford pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SLAGLE RPH (OWNER)
(814) 796-5555
Entity
Organization
Contact information
Practice address
216 HIGH ST, WATERFORD, PA 16441
(814) 796-6655
Mailing address
216 HIGH ST, WATERFORD, PA 16441
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP415468L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10077242210002
—
PA
Enumeration date
10/02/2006
Last updated
07/28/2008
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