Organization
PETROLIA PHARMACY INC
Active
Other names
Petrolia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRETTON WALBERG (OWNER)
(724) 612-2131
Entity
Organization
Contact information
Practice address
296 CHURCH STREET, PETROLIA, PA 16050
(724) 756-4050
(724) 756-4060
Mailing address
343 MERCER RD, GREENVILLE, PA 16125-9773
(724) 885-0310
(330) 876-0195
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482155
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102748846 0001
—
PA
01
—
2130724
PK
—
Enumeration date
07/13/2011
Last updated
05/27/2022
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