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Organization

MERCER MS LLC

Active
Other names
MEDICINE SHOPPE
Organization subpart
No

Provider details

NPI number
Authorized official
JUDITH DERRICK RPH (VICE PRESIDENT / SECRETARY / TREASU)
(724) 866-5814
Entity
Organization

Contact information

Practice address
315 SOUTH ERIE STREET, SUITE A, MERCER, PA 16137
(724) 662-2240
(724) 662-1904
Mailing address
315 SOUTH ERIE STREET, SUITE A, MERCER, PA 16137
(724) 662-2240
(724) 662-1904

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP410839L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021362610002
PA
01
3989906
NCPDP
PA
01
P01373089
RAILROAD MEDICARE
PA
Enumeration date
02/04/2008
Last updated
03/07/2023
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