Healthcare Provider Details

I. General information

NPI: 1457660847
Provider Name (Legal Business Name): REPETE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MAIN ST
HELLERTOWN PA
18055-1742
US

IV. Provider business mailing address

11 MAIN ST
HELLERTOWN PA
18055-1742
US

V. Phone/Fax

Practice location:
  • Phone: 610-838-3555
  • Fax: 610-838-3550
Mailing address:
  • Phone: 610-838-3555
  • Fax: 610-838-3550

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 NumberPP482076
License Number StatePA

VIII. Authorized Official

Name: LENA LASHER
Title or Position: PHARMACIST-IN-CHARGE
Credential:
Phone: 610-838-3555