Organization
SHAMOKIN PHARMACY LLC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHETAN PATEL (OWNER)
(570) 648-5242
Entity
Organization
Contact information
Practice address
605 N SHAMOKIN ST, SHAMOKIN, PA 17872-6719
(570) 648-5242
(570) 648-3606
Mailing address
605 N SHAMOKIN ST, SHAMOKIN, PA 17872-6719
(570) 648-5242
(570) 648-3606
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP414448L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031121840001
—
PA
01
—
2159095
PK
—
Enumeration date
03/26/2016
Last updated
01/18/2017
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