Organization
ENDLESS MOUNTAINS PHARMACY INC
Active
Other names
Wagner's Clifford Pharmacy, ENDLESS MOUNTAINS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SCOTT WAGNER PHARM D (OWNER)
(570) 222-7500
Entity
Organization
Contact information
Practice address
1638 STATE ROUTE 106, CLIFFORD, PA 18413
(570) 222-7500
(570) 222-7503
Mailing address
PO BOX 189, CLIFFORD, PA 18413-0189
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481127
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018873230002
—
PA
01
—
2085895
PK
—
Enumeration date
07/20/2006
Last updated
05/12/2020
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