Organization
VALENTINE PHARMACY
Active
Organization
VALENTINE PHARMACY
Active
Other names
VALENTINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MANGELLO MOLLICA R PH (OWNER)
(724) 564-1700
Entity
Organization
Contact information
Practice address
92 N MORGANTOWN ST, FAIRCHANCE, PA 15436-1038
(724) 564-1700
(724) 564-1704
Mailing address
92 N MORGANTOWN ST, FAIRCHANCE, PA 15436-1038
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481222
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19411230001
—
PA
01
—
3981645
OTHER ID NUMBER
—
Enumeration date
03/18/2006
Last updated
08/31/2007
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