Healthcare Provider Details
I. General information
NPI: 1982910774
Provider Name (Legal Business Name): WEIS MARKETS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2010
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 ROBINSON ST
BINGHAMTON NY
13904-1547
US
IV. Provider business mailing address
1000 S 2ND ST PO BOX 471
SUNBURY PA
17801-3318
US
V. Phone/Fax
- Phone: 607-772-6357
- Fax: 607-772-6392
- Phone: 570-286-3623
- Fax: 570-988-3774
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | NY |
VIII. Authorized Official
Name:
JEFFERY
MALTESE
Title or Position: VICE PRESIDENT PHARMACY
Credential: RPH
Phone: 570-863-2809