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Organization

BENTLEYVILLE MEDICINE SHOPPE INC

Active
Other names
Bentleyville Medicine Shoppe
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN DAVID CRUMRINE (PRESIDENT)
(724) 239-3600
Entity
Organization

Contact information

Practice address
808 MAIN ST, BENTLEYVILLE, PA 15314-1214
(724) 239-3600
Mailing address
808 MAIN ST, BENTLEYVILLE, PA 15314-1214
(724) 239-3600

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102979960001
PA
Enumeration date
03/18/2019
Last updated
03/18/2019
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