Organization
WILLIAM C KENNEDY
Active
Organization
WILLIAM C KENNEDY
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CHARLES KENNEDY (OWNER)
(570) 668-6366
Entity
Organization
Contact information
Practice address
56 MAUCH CHUNK ST, TAMAQUA, PA 18252-1405
(570) 668-6366
(570) 668-9019
Mailing address
56 MAUCH CHUNK ST, TAMAQUA, PA 18252-1405
(570) 668-6366
(570) 668-9019
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP410693L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007450860002
—
PA
01
—
3937046
NCPDP
—
01
—
PP410693L
STATE LIC NUMBER
PA
Enumeration date
07/17/2006
Last updated
03/07/2023
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