Healthcare Provider Details

I. General information

NPI: 1649857137
Provider Name (Legal Business Name): PRESCRIPTION CENTER- SOUTH WASHINGTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CHERRY ST STE 1A
SCRANTON PA
18505-1505
US

IV. Provider business mailing address

40 WIGHT AVE STE 100
COCKEYSVILLE MD
21030-2148
US

V. Phone/Fax

Practice location:
  • Phone: 272-228-1725
  • Fax:
Mailing address:
  • Phone: 570-343-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail 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: MICHAEL RUANE II
Title or Position: PHARMACIST
Credential:
Phone: 570-209-9900