Organization
JEFFREYS DRUG STORE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERARD OHARE (OWNER)
(724) 745-6480
Entity
Organization
Contact information
Practice address
1 N CENTRAL AVE, CANONSBURG, PA 15317-1301
(724) 745-6480
(724) 745-8818
Mailing address
1 N CENTRAL AVE, CANONSBURG, PA 15317-1301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PP411156L
PA
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1071268
—
PA
01
—
3953228
OTHER ID NUMBER
—
Enumeration date
08/13/2006
Last updated
02/03/2015
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