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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