Organization
ENDLESS MOUNTAINS PHARMACY INC
Active
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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