Organization
YANKEETOWN GOLDEN SPIKE
Active
Other names
Yankeetown Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY KUNKLE BS, MS, PHARMD (MANAGER)
(724) 471-7471
Entity
Organization
Contact information
Practice address
60 YANKEETOWN AVE, HOMER CITY, PA 15748-1011
(724) 471-7471
(724) 471-0262
Mailing address
60 YANKEETOWN AVE, HOMER CITY, PA 15748-1011
(724) 471-7471
(724) 471-0262
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
PP482660
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103133765
—
PA
01
—
2160615
PK
—
Enumeration date
04/25/2016
Last updated
03/15/2017
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