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Organization

GENMAR.EB INC.

Active
Other names
MEDICINE SHOPPE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL JOSEPH FAPORE RPH. (PHARMACIST/PRESIDENT)
(814) 443-9500
Entity
Organization

Contact information

Practice address
131 S PLEASANT AVE, SOMERSET, PA 15501-2189
(814) 443-9500
(814) 445-5410
Mailing address
131 S PLEASANT AVE, SOMERSET, PA 15501-2189

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP415233L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018101400002
PA
01
3972305
OTHER ID NUMBER
Enumeration date
09/30/2006
Last updated
04/15/2019
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