Organization
JOHN R SLAGLE
Active
Other names
TIONESTA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SLAGLE RPH (OWNER)
(814) 782-6215
Entity
Organization
Contact information
Practice address
105 FAULKNER DRIVE, TIONESTA, PA 16353
(814) 755-3557
(814) 755-3648
Mailing address
PO BOX 340, TIONESTA, PA 16353-0340
(814) 755-3557
(814) 755-3648
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP413809L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007724210004
—
PA
01
—
2085419
PK
—
Enumeration date
10/02/2006
Last updated
04/20/2016
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