Healthcare Provider Details

I. General information

NPI: 1134973811
Provider Name (Legal Business Name): PAUL B MACDONALD'S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PEACH ORCHARD RD STE 100
MC CONNELLSBURG PA
17233-8559
US

IV. Provider business mailing address

214 PEACH ORCHARD RD STE 100
MC CONNELLSBURG PA
17233-8559
US

V. Phone/Fax

Practice location:
  • Phone: 717-485-3622
  • Fax:
Mailing address:
  • Phone: 717-485-3622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID DOSCH SHETTER
Title or Position: COOWNER
Credential:
Phone: 717-485-3622