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Individual

MR. A BLAIR LUNDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
34 EAST 4TH ST, EMPORIUM, PA 15834
(814) 486-3310
(814) 486-0974
Mailing address
34 EAST 4TH ST, EMPORIUM, PA 15834
(814) 486-2326
(814) 486-1065

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP029059L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009393900002
PA
01
3989374
NCPDP
Enumeration date
04/27/2006
Last updated
04/21/2011
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