Healthcare Provider Details

I. General information

NPI: 1942208269
Provider Name (Legal Business Name): TERRANOVA RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2590 N READING RD
DENVER PA
17517-9153
US

IV. Provider business mailing address

2590 N READING RD
DENVER PA
17517-9153
US

V. Phone/Fax

Practice location:
  • Phone: 717-484-2649
  • Fax: 717-484-6056
Mailing address:
  • Phone: 717-484-2649
  • Fax: 717-484-6056

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 NumberPP414568L
License Number StatePA

VIII. Authorized Official

Name: CATHERINE ANN WISNIEWSKI
Title or Position: OWNER
Credential:
Phone: 215-260-4460