Organization
GERRITY'S SUPERMARKET, INC.
Active
Other names
Gerritys Pharmacy Keyser
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH FASULA (VICE PRESIDENT)
(570) 342-4144
Entity
Organization
Contact information
Practice address
1782 N KEYSER AVE, SCRANTON, PA 18508-1248
(570) 207-4308
(570) 207-9853
Mailing address
1782 N KEYSER AVE, SCRANTON, PA 18508-1248
(570) 207-4308
(570) 207-9853
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482203
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016870200002
—
PA
01
—
2132533
PK
—
Enumeration date
11/01/2011
Last updated
11/25/2014
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