Organization
BTBKMK LLC
Active
Other names
OLEXY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BRYK (OWNER)
(570) 562-2626
Entity
Organization
Contact information
Practice address
143 N MAIN ST, TAYLOR, PA 18517-1415
(570) 562-2626
(717) 562-2635
Mailing address
143 N MAIN ST, TAYLOR, PA 18517-1415
(570) 562-2626
(717) 562-2635
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP410613L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01970591
—
PA
01
—
2081318
PK
—
Enumeration date
06/22/2005
Last updated
12/16/2016
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