Organization
SLATEBELT DRUGS INC
Active
Other names
SLATE BELT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VISWANADHAM GADEY (PRESIDENT)
(908) 454-4352
Entity
Organization
Contact information
Practice address
435 BLUE VALLEY DR, BANGOR, PA 18013-1513
(610) 863-6001
(610) 863-8343
Mailing address
435 BLUE VALLEY DR, BANGOR, PA 18013-1513
(610) 863-6001
(610) 863-8343
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP411186L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021351390001
—
PA
01
—
3956452
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/21/2006
Last updated
02/09/2012
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