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Individual

ELAINE COUTROS BLONDEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
921 DRINKER TPKE, COVINGTON TOWNSHIP, PA 18444-7947
(570) 842-7848
Mailing address
302 HILLSIDE DR, MOSCOW, PA 18444-8624
(570) 650-6306

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
RI01689000
NJ
183500000X
Pharmacist
Primary
RP032788L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RI01689000
PHARMACY LICENSE
NJ
01
RP032788L
PHARMACY LICENSE
PA
Enumeration date
03/18/2016
Last updated
03/18/2016
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