Organization
LINESVILLE PHARMACY INC
Active
Other names
Linesville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRETTON WALBERG (OWNER)
(724) 612-2131
Entity
Organization
Contact information
Practice address
123 W ERIE ST, LINESVILLE, PA 16424-9227
(814) 818-0010
(814) 818-0024
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
PP482375
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029111950001
—
PA
01
—
2138478
PK
—
Enumeration date
04/15/2013
Last updated
05/27/2022
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