Healthcare Provider Details

I. General information

NPI: 1245228477
Provider Name (Legal Business Name): STARWOOD DRUG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 LIGONIER ST
LATROBE PA
15650-1837
US

IV. Provider business mailing address

1006 LIGONIER ST
LATROBE PA
15650-1837
US

V. Phone/Fax

Practice location:
  • Phone: 724-537-6841
  • Fax: 724-539-9486
Mailing address:
  • Phone: 724-537-6841
  • Fax: 724-539-9486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP411638L
License Number StatePA

VIII. Authorized Official

Name: MRS. TRACY G. ROSKY
Title or Position: REGISTERED PHARMACIST
Credential: RPH
Phone: 724-537-6841