Healthcare Provider Details

I. General information

NPI: 1275668758
Provider Name (Legal Business Name): HOFFMAN'S DRUG STORE,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 FRANKLIN AVE
ALIQUIPPA PA
15001-3728
US

IV. Provider business mailing address

PO BOX 429 536 FRANKLIN AVE
ALIQUIPPA PA
15001-0429
US

V. Phone/Fax

Practice location:
  • Phone: 724-375-4111
  • Fax: 724-375-9419
Mailing address:
  • Phone: 724-375-4111
  • Fax: 724-375-9419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP411073L
License Number StatePA

VIII. Authorized Official

Name: MR. EMANUEL N PANOS
Title or Position: PRESIDENT
Credential: RPH
Phone: 724-375-4111