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NPI Code Detail

MEDICARE: WEIS MARKETS INC

MEDICARE: WEIS MARKETS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyPP414160LPA
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23957555OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205869534
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEIS MARKETS INC
Provider Business Mailing Address
First Line : 1000 S 2ND ST
Second Line : PO BOX 471
City : SUNBURY
State : PA
Zip : 17801-3318
Country : US
Telephone Number : 570-286-3623
Fax Number : 570-988-3774
Provider Business Practice Location Address
First Line : 3885 UNION DEPOSIT RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17109-5920
Country : US
Telephone Number : 717-558-9407
Fax Number : 717-558-9202
Authorized Official
Title or Position : VICE PRESIDENT PHARMACY
Name : JEFFERY MALTESE
Credential : RPH
Telephone Number : 570-863-2809
Provider Enumeration Date : 07/09/2006
Last Update Date : 02/11/2008

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Directions to “WEIS MARKETS INC ” Practice Location

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