Organization
FAMILY PHARMACY OF CARBONDALE INC
Active
Organization
FAMILY PHARMACY OF CARBONDALE INC
Active
Other names
Family Pharmacy of Carbondale INC
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS DOUGHERTY (PRESIDENT)
(570) 499-1900
Entity
Organization
Contact information
Practice address
70 N CHURCH ST, CARBONDALE, PA 18407-1912
(570) 281-6300
(570) 281-6301
Mailing address
70 N CHURCH ST, CARBONDALE, PA 18407-1912
(570) 281-6300
(570) 281-6301
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP482725
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP482725
PA
3336C0004X
Compounding Pharmacy
PP482725
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169881
PK
—
Enumeration date
06/16/2017
Last updated
07/11/2017
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