Healthcare Provider Details

I. General information

NPI: 1780290197
Provider Name (Legal Business Name): WEIS MARKETS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 09/21/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ATLANTIC AVE.
DINGMANS FERRY PA
18328
US

IV. Provider business mailing address

PO BOX 471
SUNBURY PA
17801-0471
US

V. Phone/Fax

Practice location:
  • Phone: 570-832-0294
  • Fax:
Mailing address:
  • Phone: 570-286-3623
  • Fax: 570-988-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RICHARD W SEIPP
Title or Position: VICE PRESIDENT, PHARMACY
Credential: RPH
Phone: 570-863-2812