Healthcare Provider Details

I. General information

NPI: 1598375875
Provider Name (Legal Business Name): GANSE APOTHECARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 CONNELLSVILLE RD STE 200
LEMONT FURNACE PA
15456-1009
US

IV. Provider business mailing address

40 WIGHT AVE STE 100
COCKEYSVILLE MD
21030-2148
US

V. Phone/Fax

Practice location:
  • Phone: 724-655-6636
  • Fax: 717-394-4566
Mailing address:
  • Phone: 667-408-7767
  • Fax: 717-394-4566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GREG GANSE
Title or Position: CEO
Credential:
Phone: 717-394-5671