Organization
KINSLEYS MARKET OF TANNERSVILLE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
107 KINSLEY DR, BRODHEADSVILLE, PA 18322-7800
(570) 992-2670
(570) 992-2877
Mailing address
PO BOX 760, BRODHEADSVILLE, PA 18322-0760
(570) 992-2670
(570) 992-2877
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3988017
NCPDP
PA
Enumeration date
02/23/2007
Last updated
09/03/2015
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