Organization
LIFE TREE PHARMACY SERVICES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TAGLIANETTI (CEO)
(610) 489-6640
Entity
Organization
Contact information
Practice address
120 PARK CENTER DRIVE, BROUSSARD, LA 70518-3605
(610) 489-6640
(610) 489-6645
Mailing address
5 BLUE HERON DRIVE, COLLEGEVILLE, PA 19426-2057
(610) 489-6640
(610) 489-6645
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
10/24/2018
Last updated
07/17/2019
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