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NPI Code Detail

MEDICARE: BROCKIE HEALTHCARE INC

MEDICARE: BROCKIE HEALTHCARE 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
13336L0003XLong Term Care PharmacyPP415755LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
33978600OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1790841062
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROCKIE HEALTHCARE INC
Provider Business Mailing Address
First Line : 118 PLEASANT ACRES RD
Second Line :
City : YORK
State : PA
Zip : 17402-8975
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 118 PLEASANT ACRES RD
Second Line :
City : YORK
State : PA
Zip : 17402-8975
Country : US
Telephone Number : 717-840-7144
Fax Number : 717-757-5756
Authorized Official
Title or Position : VP OF OPR
Name : JOHN GILLESPIE
Credential : RPH
Telephone Number : 717-848-3445
Provider Enumeration Date : 12/29/2006
Last Update Date : 08/22/2020

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Directions to “BROCKIE HEALTHCARE INC ” Practice Location

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