Organization
SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE
Active
Other names
SHADY MAPLE PHARMACY AT GARDEN SPOT VILLAGE
Organization subpart
No
Provider details
NPI number
Authorized official
ELWOOD MARTIN (PRESIDENT)
(717) 354-4891
Entity
Organization
Contact information
Practice address
433 S KINZER AVE, NEW HOLLAND, PA 17557-8736
(717) 355-6155
(717) 355-6156
Mailing address
433 S KINZER AVE, NEW HOLLAND, PA 17557-8736
(717) 355-6155
(717) 355-6156
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482276
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139988
PK
—
Enumeration date
04/22/2013
Last updated
04/22/2013
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