Organization
MAIN STREET DRUG STORE INC
Active
Organization
MAIN STREET DRUG STORE INC
Active
Other names
Everett Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN ISEMINGER (AUTHORIZED OFFICIAL)
(814) 652-5532
Entity
Organization
Contact information
Practice address
108 E MAIN ST, EVERETT, PA 15537-1258
(814) 652-5532
(814) 652-2927
Mailing address
108 E MAIN ST, EVERETT, PA 15537-1258
(814) 652-5532
(814) 652-2927
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP410712L
PA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022770360001
—
PA
01
—
3991761
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
559319
—
PA
Enumeration date
02/13/2009
Last updated
12/19/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up