Organization
MOSHANNON VALLEY PHARMACY INC
Active
Organization
MOSHANNON VALLEY PHARMACY INC
Active
Other names
MOSHANNON VALLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BRANSTETTER (MANAGER OF PHARMACIES)
(814) 342-5200
Entity
Organization
Contact information
Practice address
208 MEDICAL CENTER DR, PHILIPSBURG, PA 16866-1948
(814) 342-5200
(814) 342-6749
Mailing address
1605 WASHINGTON AVENUE, PO BOX 529, HYDE, PA 16843-0529
(814) 765-1800
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP413567L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007479930001
—
PA
01
—
3928770
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/21/2006
Last updated
11/26/2012
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