Organization
SOUTHMOORE PHARMACY LLC
Active
Other names
SouthMoore Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN WEBER (PARTNER)
(484) 287-6337
Entity
Organization
Contact information
Practice address
2453 PLAZA CT STE A, BATH, PA 18014-8762
(484) 287-6337
(484) 287-6340
Mailing address
2453 PLAZA CT STE A, BATH, PA 18014
(484) 287-6337
(484) 287-6340
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482196
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3997181
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/19/2012
Last updated
01/13/2014
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