Organization
SALEM CROSSROADS APOTHECARY LLC
Active
Other names
SALEM CRSSRDS APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS JAMES KIESEL (OWNER)
(724) 468-5565
Entity
Organization
Contact information
Practice address
195 SHEFFIELD DR STE B, DELMONT, PA 15626-1744
(724) 468-5565
(724) 468-8336
Mailing address
195 SHEFFIELD DR STE B, DELMONT, PA 15626-1744
(724) 468-5565
(724) 468-8336
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP410636L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1042405450001
—
PA
01
—
2082625
PK
—
Enumeration date
11/03/2006
Last updated
11/07/2023
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