Organization
MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY DOUGALAS RPH (OWNER PHARMACIST)
(570) 735-5114
Entity
Organization
Contact information
Practice address
69 N MARKET ST, NANTICOKE, PA 18634-1553
(570) 735-5114
(570) 735-6624
Mailing address
69 N MARKET ST, NANTICOKE, PA 18634-1553
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP412490L
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3942439
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
03/07/2023
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