Healthcare Provider Details

I. General information

NPI: 1780681676
Provider Name (Legal Business Name): MANNS DRUG STORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 LINCOLN WAY
WHITE OAK PA
15131-1301
US

IV. Provider business mailing address

1101 LINCOLN WAY
WHITE OAK PA
15131-1301
US

V. Phone/Fax

Practice location:
  • Phone: 412-672-7617
  • Fax: 412-672-6770
Mailing address:
  • Phone: 412-672-7617
  • Fax: 412-672-6770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. DAVID W MANNS
Title or Position: MGR/OWNER
Credential:
Phone: 412-672-7617