Organization
ALTOONA PHARMACY INC
Active
Organization
ALTOONA PHARMACY INC
Active
Other names
Altoona Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRETTON WALBERG (OWNER)
(724) 612-2131
Entity
Organization
Contact information
Practice address
620 HOWARD AVE, BLDG G SUITE 403, ALTOONA, PA 16601-4804
(814) 283-0602
(814) 283-0606
Mailing address
PO BOX 103, TRANSFER, PA 16154-0103
(724) 646-1131
(724) 646-1177
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482174
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102748855 0001
—
PA
01
—
2130726
PK
—
Enumeration date
11/30/2011
Last updated
07/17/2015
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