Organization
COSTA DRUGS INC
Active
Other names
COSTA DRUGS INC
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE CHELLAND RPH (CORP SEC)
(570) 961-1168
Entity
Organization
Contact information
Practice address
609 PROSPECT AVE, SCRANTON, PA 18505-2772
(570) 961-1168
(570) 207-4633
Mailing address
609 PROSPECT AVE, SCRANTON, PA 18505-2772
(570) 961-1168
(570) 207-4633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP410487L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007612680003
—
PA
01
—
2078775
PK
—
Enumeration date
11/14/2006
Last updated
09/09/2013
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