Organization
DERRY STREET PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJU KATLA RPH (PHARMACY MANAGER)
(717) 547-6219
Entity
Organization
Contact information
Practice address
1304 DERRY ST, HARRISBURG, PA 17104-1184
(717) 547-6219
Mailing address
1304 DERRY ST, HARRISBURG, PA 17104-1184
(717) 547-6219
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP482814
PA
3336C0003X
Community/Retail Pharmacy
PP482814
PA
Other
Enumeration date
08/31/2018
Last updated
01/05/2024
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