Organization
MEDICAL SHOPPE LTD
Active
Other names
Stephens Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH A STEPHENS RN (PRESIDENT)
(570) 253-7700
Entity
Organization
Contact information
Practice address
1101 MAIN ST, HONESDALE, PA 18431-1907
(570) 253-7770
(570) 251-7809
Mailing address
1101 MAIN ST., HONESDALE, PA 18431
(570) 253-7770
(570) 251-7809
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP414702L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007436710003
—
PA
Enumeration date
07/19/2005
Last updated
08/24/2007
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