Organization
G. SPEARING WEISS LLC
Active
Other names
Blakeslee Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN S. WEISS RPH (PHARMACIST/OWNER)
(570) 646-8040
Entity
Organization
Contact information
Practice address
393 RT 940, SUITE 1, BLAKESLEE, PA 18610
(570) 646-8040
(570) 643-9031
Mailing address
PO BOX 648, BLAKESLEE, PA 18610
(570) 646-8040
(570) 643-9031
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP412175L
PA
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2081195
PK
—
05
—
7575708
—
PA
Enumeration date
03/13/2007
Last updated
10/24/2019
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