Organization
SHADY MAPLE PHARMACY
Active
Organization
SHADY MAPLE PHARMACY
Active
Other names
SHADY MAPLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S EAST (PHARMACIST IN CHARGE)
(717) 355-9424
Entity
Organization
Contact information
Practice address
1324 MAIN ST, EAST EARL, PA 17519-9508
(717) 355-9424
(717) 351-0253
Mailing address
PO BOX 137, EAST EARL, PA 17519-0137
(717) 355-9424
(717) 351-0253
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481512
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014656950001
—
PA
01
—
2087490
PK
—
Enumeration date
06/20/2006
Last updated
07/11/2025
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