Organization
BRACEY'S MOUNT POCONO, INC.
Active
Organization
BRACEY'S MOUNT POCONO, INC.
Active
Other names
Bill's Shoprite Pharmacy Mt. Pocono
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA-RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
89 STATE ROUTE 940, MOUNT POCONO, PA 18344-1426
(570) 839-5340
Mailing address
921 DRINKER TPKE, COVINGTON TOWNSHIP, PA 18444-7947
(570) 842-7461
(570) 842-6520
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP481373
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009983850001
—
PA
01
—
3983233
NCPDP
—
Enumeration date
10/26/2006
Last updated
03/30/2011
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