Organization
OM SAIDEV LLC
Active
Other names
Longenecker Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
UMAMAHESWARA DONEPUDI (MEMBER)
(717) 442-9523
Entity
Organization
Contact information
Practice address
5360 LINCOLN HWY, SUITE 10, GAP, PA 17527-9451
(717) 442-9523
(717) 442-5246
Mailing address
5360 LINCOLN HWY, SUITE 10, GAP, PA 17527-9451
(717) 442-9523
(717) 442-5246
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP411414L
PA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029008520001
—
PA
01
—
2144225
PK
—
Enumeration date
06/22/2006
Last updated
01/18/2017
About Stedi
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