Healthcare Provider Details

I. General information

NPI: 1164106290
Provider Name (Legal Business Name): GEISINGER PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
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 # MC24-04
DANVILLE PA
17822-2404
US

V. Phone/Fax

Practice location:
  • Phone: 717-363-9315
  • Fax: 717-363-9316
Mailing address:
  • Phone: 570-271-7965
  • Fax: 570-271-7370

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: MICHAEL A EVANS
Title or Position: CHIEF PHARMACY OFFICER
Credential:
Phone: 570-271-6192