Organization
KRYNICKI INC
Active
Organization
KRYNICKI INC
Active
Other names
Dierken's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RON MCDERMOTT (SVP OPERATIONS)
(330) 318-3926
Entity
Organization
Contact information
Practice address
100 E MAIN ST, MONONGAHELA, PA 15063-2360
(724) 258-5530
(724) 258-4448
Mailing address
8751 FOXWOOD CT, SUITE A, POLAND, OH 44514
(330) 318-3926
(330) 318-3927
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP410597L
PA
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102896517-0001
—
PA
01
—
2144894
PK
—
01
—
747109
MEDICARE PTAN
PA
Enumeration date
08/05/2007
Last updated
03/08/2022
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