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)
(814) 387-4014
Entity
Organization
Contact information
Practice address
402 E SYCAMORE RD, SNOW SHOE, PA 16874-8832
(814) 387-4014
(814) 387-6934
Mailing address
1605 WASHINGTON AVENUE, PO BOX 529, HYDE, PA 16843-0529
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP412361L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007479930009
—
PA
01
—
2085757
PK
—
Enumeration date
07/26/2006
Last updated
01/19/2017
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