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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