Organization
JONICO INC
Active
Other names
Yough Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D JACOBS RPH (OWNER)
(814) 445-6089
Entity
Organization
Contact information
Practice address
511 WILLIAMS ST, SUITE #2, CONFLUENCE, PA 15424-1048
(814) 395-5300
Mailing address
511 WILLIAMS ST, SUITE #2, CONFLUENCE, PA 15424-1048
(814) 395-5300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP410073L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007513050009
—
PA
Enumeration date
01/09/2007
Last updated
08/19/2011
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