Healthcare Provider Details
I. General information
NPI: 1215087242
Provider Name (Legal Business Name): GEISINGER PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2007
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 GATEWAY DR
REEDSVILLE PA
17084-9641
US
IV. Provider business mailing address
100 N ACADEMY AVE
DANVILLE PA
17822-2575
US
V. Phone/Fax
- Phone: 717-363-9315
- Fax: 717-363-9316
- Phone: 570-271-7965
- Fax: 570-271-7370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PP414038L |
| License Number State | PA |
VIII. Authorized Official
Name:
MICHAEL
A
EVANS
Title or Position: VP ENTERPRISE PHARMACY
Credential:
Phone: 570-271-6192