Healthcare Provider Details

I. General information

NPI: 1740388776
Provider Name (Legal Business Name): DIXONS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3463 BIGLERVILLE RD
BIGLERVILLE PA
17307-9809
US

IV. Provider business mailing address

3463 BIGLERVILLE RD PO BOX 481
BIGLERVILLE PA
17307-9809
US

V. Phone/Fax

Practice location:
  • Phone: 717-677-8144
  • Fax: 717-677-9694
Mailing address:
  • Phone: 717-677-8144
  • Fax: 717-677-9694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP413295L
License Number StatePA

VIII. Authorized Official

Name: BRYAN GOBIN
Title or Position: TREASURER
Credential: RPH
Phone: 717-486-8606