Organization
MMJM INC
Active
Other names
FIGLIOMENI PHARMACY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MANCUSO (PRES)
(570) 282-6046
Entity
Organization
Contact information
Practice address
19 DUNDAFF ST, 2ND FLOOR STE, CARBONDALE, PA 18407-1828
(570) 282-1080
(570) 282-1815
Mailing address
19 DUNDAFF ST, 2ND FLOOR STE, CARBONDALE, PA 18407-1828
(570) 282-1080
(570) 282-1815
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PP481717
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101902594
—
PA
01
—
2081860
PK
—
Enumeration date
05/22/2007
Last updated
01/13/2017
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