Organization
OTT AND MCHENRY PHARMACY , INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DOLAN (OWNER, RPH)
(814) 362-3827
Entity
Organization
Contact information
Practice address
102 MAIN ST, BRADFORD, PA 16701-2023
(814) 362-3827
(814) 363-9844
Mailing address
102 MAIN ST, BRADFORD, PA 16701-2023
(814) 362-3827
(814) 363-9844
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP411739L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102152944
—
PA
Enumeration date
03/24/2007
Last updated
03/27/2009
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