Organization
ANTIETAM APOTHECARY INC
Active
Organization
ANTIETAM APOTHECARY INC
Active
Other names
Waynesboro Apothecary, ANTIETAM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT NORRIS III (OFFICER)
(717) 504-2159
Entity
Organization
Contact information
Practice address
604 E MAIN ST, WAYNESBORO, PA 17268-2387
(717) 762-2915
(717) 762-2357
Mailing address
604 E MAIN ST, WAYNESBORO, PA 17268-2387
(717) 762-2915
(717) 762-2357
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP412558L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001017808
—
PA
01
—
3950070
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/31/2005
Last updated
10/07/2024
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