Organization
GLAD RX LLC
Active
Other names
Glad Rx
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISA WASCHKO (OWNER/PHARMACY MANAGER)
(570) 739-7241
Entity
Organization
Contact information
Practice address
216 N ROUTE 183, SCHUYLKILL HAVEN, PA 17972-8828
(570) 739-7142
(570) 739-7162
Mailing address
216 N ROUTE 183, SCHUYLKILL HAVEN, PA 17972-8828
(570) 739-7142
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482135
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3995656
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/30/2011
Last updated
07/13/2011
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