Organization
SRI GANESH PHARMACY OF HYNDMAN INC
Active
Other names
Potomac Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TEJAS SHETH (VICE PRESIDENT)
(814) 842-3201
Entity
Organization
Contact information
Practice address
138 WASHINGTON ST, HYNDMAN, PA 15545
(814) 842-3201
(814) 842-3711
Mailing address
PO BOX 694, 138 WASHINGTON ST, HYNDMAN, PA 15545
(814) 842-3201
(814) 842-3711
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP411775L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002202101
—
MD
05
—
1007630390003
—
PA
Enumeration date
11/09/2006
Last updated
02/20/2015
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