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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