Healthcare Provider Details

I. General information

NPI: 1508446212
Provider Name (Legal Business Name): TERRANOVA RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
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:
Mailing address:
  • Phone: 717-484-2649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CATHERINE WISNIEWSKI
Title or Position: PRESIDENT
Credential: RPH
Phone: 717-336-2292