Organization
NORTHERN ADVENTURES INC.
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN JAMES HAYLETT R.PH. (OWNER)
814337888025
Entity
Organization
Contact information
Practice address
629 STATE ST, MEADVILLE, PA 16335-2262
(814) 337-8880
(814) 333-4197
Mailing address
629 STATE ST, PO BOX 805, MEADVILLE, PA 16335-2262
(814) 337-8880
(814) 333-4197
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP413389L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022544990001
—
PA
01
—
3935650
NCPDP #
PA
Enumeration date
07/09/2006
Last updated
03/07/2023
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