Organization
FORLENZA'S PHARMACY
Active
Other names
Forlenza's Nutritional-Wellness Center and Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PAUL FORLENZA P.D. (OWNER/MANAGER)
(570) 288-6626
Entity
Organization
Contact information
Practice address
531 MAIN ST, EDWARDSVILLE, PA 18704-2597
(570) 288-6626
(570) 288-9764
Mailing address
531 MAIN ST, EDWARDSVILLE, PA 18704-2597
(570) 288-6626
(570) 288-9764
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PP-411080-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24-001095690-0002
—
PA
05
—
24001095690-0001
—
PA
01
—
39-54496
NCPDP
—
01
—
A08000792
SUBMITTER ID#
—
Enumeration date
06/08/2005
Last updated
10/20/2016
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