Organization
SUSAN L GRANCEY
Active
Organization
SUSAN L GRANCEY
Active
Other names
MEDICINE SHOPPE 0082
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GRANCEY RPH (OWNER)
(814) 765-5372
Entity
Organization
Contact information
Practice address
304 N 3RD ST, CLEARFIELD, PA 16830-2527
(814) 765-5371
(814) 762-8755
Mailing address
304 N 3RD ST, CLEARFIELD, PA 16830-2527
(814) 765-5371
(814) 762-8755
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP413612L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015033180001
—
PA
01
—
2082296
PK
—
Enumeration date
09/16/2006
Last updated
07/24/2013
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