Organization
TALC CORP
Active
Other names
Wesley Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRENCE T BAIRD (OWNER/PRESIDENT)
(215) 884-2990
Entity
Organization
Contact information
Practice address
108 110 S. EASTON RD., GLENSIDE, PA 19038-0249
(215) 887-4577
(215) 887-4505
Mailing address
PO BOX 249, GLENSIDE, PA 19038-0249
(215) 887-4577
(215) 887-4505
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
—
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP4128467
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0564220
—
PA
01
—
91931
AETNA
PA
Enumeration date
07/07/2005
Last updated
07/21/2022
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