Organization
EDPHARMALLC
Active
Other names
Edpharmallc
Organization subpart
No
Provider details
NPI number
Authorized official
EDMUND POTOCKI (OWNER)
(570) 223-2600
Entity
Organization
Contact information
Practice address
123 COLUMBIA DR., MARSHALLS CREEK, PA 18335
(570) 223-2600
Mailing address
PO BOX 1399, MARSHALLS CREEK, PA 18335-1399
(570) 223-2600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP4822308
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144584
PK
—
Enumeration date
03/11/2014
Last updated
03/11/2014
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