Healthcare Provider Details

I. General information

NPI: 1306973391
Provider Name (Legal Business Name): VACCARE PHARMACY , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N MAIN ST
GREENSBURG PA
15601-2404
US

IV. Provider business mailing address

110 N MAIN ST
GREENSBURG PA
15601-2404
US

V. Phone/Fax

Practice location:
  • Phone: 724-827-1260
  • Fax: 724-837-1261
Mailing address:
  • Phone: 724-827-1260
  • Fax: 724-837-1261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP412753L
License Number StatePA

VIII. Authorized Official

Name: MRS. ESTHER R RAHL
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 724-837-1260