Organization
TIBBOTTS PHARMACY INC
Active
Other names
TIBBOTTS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ROWLAND TIBBOTT RPH (OWNER)
(814) 472-9390
Entity
Organization
Contact information
Practice address
1104 W HIGH ST, STE1, KIMBALL PLAZA, EBENSBURG, PA 15931-1707
(814) 472-9390
(814) 472-1166
Mailing address
1104 W HIGH ST, BOX 179, EBENSBURG, PA 15931-1707
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP412694L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000933360
—
PA
01
—
3911636
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/20/2006
Last updated
08/19/2011
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