Healthcare Provider Details

I. General information

NPI: 1518339571
Provider Name (Legal Business Name): WELLSPAN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 N READING RD STE 9 SUITE 9
EPHRATA PA
17522-1647
US

IV. Provider business mailing address

PO BOX 20129
YORK PA
17402-0140
US

V. Phone/Fax

Practice location:
  • Phone: 717-721-5784
  • Fax: 717-733-0025
Mailing address:
  • Phone: 717-851-6903
  • Fax: 717-851-5407

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 NumberPP482606
License Number StatePA

VIII. Authorized Official

Name: MR. KEVIN CHARNETSKI
Title or Position: DIRECTOR
Credential: PHARM D
Phone: 570-262-6663