Organization
WEIS MARKETS INC
Active
Other names
WEIS PHARMACY #090
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS J. CICCO PHARM D (VICE PRESIDENT, PHARMACY)
(570) 286-3201
Entity
Organization
Contact information
Practice address
10122 OLD NATIONAL PIKE, IJAMSVILLE, MD 21754-9722
(240) 915-6253
(223) 204-5245
Mailing address
PO BOX 471, SUNBURY, PA 17801-0471
(570) 286-3623
(570) 988-3774
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0349270170
MEDICARE DMEPOS
MD
01
—
2146000
NCPDP
MD
05
—
231089900
—
MD
Enumeration date
03/04/2025
Last updated
08/14/2025
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