Healthcare Provider Details

I. General information

NPI: 1811878101
Provider Name (Legal Business Name): JL SLOCUM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 S MAIN ST STE 1
OLD FORGE PA
18518-1497
US

IV. Provider business mailing address

821 S MAIN ST STE 1
OLD FORGE PA
18518-1497
US

V. Phone/Fax

Practice location:
  • Phone: 570-457-3200
  • Fax: 570-457-3220
Mailing address:
  • Phone: 570-457-3200
  • Fax: 570-457-3220

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: LORI ANN SLOCUM
Title or Position: OWNER/PHARMACIST
Credential: PHARMD
Phone: 570-457-3200