Organization
LIGONIER PHARMACY, INC.
Active
Other names
Ligonier Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA LYNN NEIDERHISER R.PH. (PIC)
(724) 238-6988
Entity
Organization
Contact information
Practice address
113 S FAIRFIELD ST, STE 1, LIGONIER, PA 15658-1163
(724) 238-6988
(724) 238-7781
Mailing address
113 S FAIRFIELD ST, STE 1, LIGONIER, PA 15658-1163
(724) 238-6988
(724) 238-7781
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP413303L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010774950001
—
PA
01
—
2085426
PK
—
01
—
3951755
NCPDP
—
Enumeration date
10/11/2005
Last updated
01/14/2019
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