Organization
WELLSPAN PHARMACY, INC.
Active
Other names
Wellspan Infusion Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN CHARNETSKI (SENIOR PHARMACY MANAGER)
(570) 262-6663
Entity
Organization
Contact information
Practice address
304 SAINT CHARLES WAY, YORK, PA 17402-4647
(717) 851-5891
(717) 851-5897
Mailing address
PO BOX 20129, YORK, PA 17402-0140
(717) 851-5891
(717) 851-5897
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PP415727L
PA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PP415727L
PA
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PP415727L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007746500001
—
PA
01
—
325770004
MEDICARE PART B
PA
Enumeration date
01/15/2007
Last updated
11/02/2023
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