Organization
WARREN MS LLC
Active
Organization
WARREN MS LLC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD M DERRICK (OWNER)
(814) 726-3741
Entity
Organization
Contact information
Practice address
3 PENNSYLVANIA AVE E, WARREN, PA 16365-2526
(814) 726-3741
Mailing address
3 PENNSYLVANIA AVE E, WARREN, PA 16365-2526
(814) 726-3741
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020774830001
—
PA
01
—
3989475
NCPDP #
PA
Enumeration date
12/07/2007
Last updated
03/07/2023
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