Organization
SAVED BY GRACE INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN KAMINSKI RPH (OWNER)
(570) 323-7733
Entity
Organization
Contact information
Practice address
507 HEPBURN ST, WILLIAMSPORT, PA 17701-5004
(570) 854-7669
(570) 323-9149
Mailing address
507 HEPBURN ST, WILLIAMSPORT, PA 17701-5004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
PP414026L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015144950001
—
PA
01
—
3955513
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
03/07/2023
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