Healthcare Provider Details

I. General information

NPI: 1962979708
Provider Name (Legal Business Name): NOCKLEY FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S MAIN AVE STE 100
SCRANTON PA
18504-2956
US

IV. Provider business mailing address

1150 S MAIN AVE STE 100
SCRANTON PA
18504-2956
US

V. Phone/Fax

Practice location:
  • Phone: 570-207-1318
  • Fax: 570-207-1317
Mailing address:
  • Phone: 570-207-1318
  • Fax: 570-207-1317

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: DR. DAVID LEE NOCKLEY
Title or Position: OWNER
Credential: PHARMD
Phone: 570-208-5500