Healthcare Provider Details

I. General information

NPI: 1538146444
Provider Name (Legal Business Name): JANICE E OLCESE PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W SPRUCE ST TOM OLCESE PHARMACY
SHAMOKIN PA
17872-5716
US

IV. Provider business mailing address

406 E CAMERON ST
SHAMOKIN PA
17872-5716
US

V. Phone/Fax

Practice location:
  • Phone: 570-648-7891
  • Fax: 570-648-2007
Mailing address:
  • Phone: 570-648-4876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP035719L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: