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Organization

JL SLOCUM LLC

Active
Other names
Old Forge Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
LORI ANN SLOCUM PHARMD (PHARMACIST)
(570) 430-1990
Entity
Organization

Contact information

Practice address
821 S MAIN ST, SUITE 1, OLD FORGE, PA 18518-1497
(570) 457-3200
(570) 457-3220
Mailing address
821 S MAIN ST, SUITE 1, OLD FORGE, PA 18518-1497
(570) 457-3200
(570) 457-3220

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP046173
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP482577
PA

Other

Enumeration date
08/12/2015
Last updated
07/12/2016
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