Organization
BRIGADOON INC
Active
Other names
LIONVILLE NATURAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRIGGS (PHARMACY MANAGER AND CO OWNER)
(610) 363-7474
Entity
Organization
Contact information
Practice address
200 E UWCHLAN AVE, EXTON, PA 19341-1207
(610) 363-7474
(610) 363-5707
Mailing address
200 E UWCHLAN AVE, EXTON, PA 19341-1207
(610) 363-7474
(610) 363-5707
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PP411861L
PA
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2083980
PK
—
Enumeration date
12/06/2006
Last updated
12/18/2015
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