Organization
GREBLAW INC
Active
Other names
Jamestown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRETTON CLARK WALBERG RPH (PRESIDENT)
(724) 612-2131
Entity
Organization
Contact information
Practice address
121 LIBERTY ST, JAMESTOWN, PA 16134-0395
(724) 932-5355
(724) 932-3943
Mailing address
30 CONNEAUT LAKE RD, GREENVILLE, PA 16125-2167
(724) 885-0310
(724) 885-0330
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP413647L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17752920001
—
PA
Enumeration date
02/21/2007
Last updated
06/12/2024
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