Organization
WATTERS BROS DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT H KERR SR. RPH (CO OWNER)
(814) 948-6720
Entity
Organization
Contact information
Practice address
4105 CRAWFORD AVE, NORTHERN CAMBRIA, PA 15714-1341
(814) 948-6720
(814) 948-4933
Mailing address
4105 CRAWFORD AVE, PO BOX 1067, NORTHERN CAMBRIA, PA 15714-1341
(814) 948-6720
(814) 948-4933
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PP412829L
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP412829L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005678670002
—
PA
01
—
0390963
PACE
PA
01
—
3909631
NASP
—
Enumeration date
12/16/2005
Last updated
07/05/2013
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