Healthcare Provider Details

I. General information

NPI: 1134175581
Provider Name (Legal Business Name): GEISINGER PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 WOODBINE LN
DANVILLE PA
17821-8020
US

IV. Provider business mailing address

100 N ACADEMY AVE # MC24-01
DANVILLE PA
17822-2401
US

V. Phone/Fax

Practice location:
  • Phone: 570-214-8503
  • Fax: 570-271-5843
Mailing address:
  • Phone: 570-214-8503
  • Fax: 570-271-7953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberPP414060L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL EVANS
Title or Position: VP ENTERPRISE PHARMACY
Credential:
Phone: 570-271-6192