Organization
JONICO INC
Active
Other names
Berlin Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D JACOBS RPH (OWNER)
(814) 445-6089
Entity
Organization
Contact information
Practice address
413 BROADWAY ST, BERLIN, PA 15530-1001
(814) 267-4013
Mailing address
603 ANTRAM RD, SOMERSET, PA 15501-8861
(814) 267-4013
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP412109L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007513050003
—
PA
Enumeration date
01/09/2007
Last updated
07/09/2025
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