Organization
BOLTINGHOUSE CORPORATION
Active
Other names
Burch Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN KAYE BOLTINGHOUSE RPH (PHARMACIST IN CHARGE/PRESIDENT)
(570) 672-2711
Entity
Organization
Contact information
Practice address
120 W VALLEY AVE, ELYSBURG, PA 17824-9703
(570) 672-2711
(570) 672-1311
Mailing address
120 W VALLEY AVE, ELYSBURG, PA 17824-9703
(570) 672-2711
(570) 672-1311
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP410295L
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP410295L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241025591500001
—
PA
01
—
3917246
NCPDP NUMBER
—
01
—
RPI002230
AUTHORIZATION TO ADMINISTER INJECTABLES
PA
Enumeration date
02/09/2007
Last updated
09/19/2011
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