Organization
MARYSIA INC
Active
Other names
The Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD MCDERMOTT (SVP OPERATIONS)
(330) 318-3926
Entity
Organization
Contact information
Practice address
3 NORTHGATE PLZ, UNIT 2, HARMONY, PA 16037-9257
(724) 452-5334
(724) 452-5592
Mailing address
8571 FOXWOOD CT, SUITE A, POLAND, OH 44514-4313
(330) 318-3926
(330) 318-3927
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481568
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101636792-001
—
PA
01
—
2087766
PK
—
Enumeration date
06/19/2006
Last updated
04/21/2023
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