Healthcare Provider Details

I. General information

NPI: 1144411430
Provider Name (Legal Business Name): KRYNICKI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E MAIN ST
MONONGAHELA PA
15063-2360
US

IV. Provider business mailing address

8751 FOXWOOD CT SUITE A
POLAND OH
44514
US

V. Phone/Fax

Practice location:
  • Phone: 724-258-5530
  • Fax: 724-258-4448
Mailing address:
  • Phone: 330-318-3926
  • Fax: 330-318-3927

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 NumberPP410597L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RON MCDERMOTT
Title or Position: SVP OPERATIONS
Credential:
Phone: 330-318-3926