Organization
BURRELL PHARMACY INC
Active
Other names
Leechburg Pharmacy Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER J MICKLOW R.PH. (SECRETARY)
(724) 845-1184
Entity
Organization
Contact information
Practice address
111 2ND ST, LEECHBURG, PA 15656-1326
(724) 845-1184
(724) 842-2071
Mailing address
111 2ND ST, SUITE 200, LEECHBURG, PA 15656-1326
(724) 845-1184
(724) 842-2071
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PP414776L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007627200003
—
PA
01
—
3967215
NCPDP
PA
Enumeration date
10/21/2006
Last updated
05/02/2012
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