Healthcare Provider Details

I. General information

NPI: 1912066168
Provider Name (Legal Business Name): JIUNTA'S PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 CAREY AVE
WILKES BARRE PA
18702-2133
US

IV. Provider business mailing address

342 CAREY AVE
WILKES BARRE PA
18702-2133
US

V. Phone/Fax

Practice location:
  • Phone: 570-823-1116
  • Fax: 570-823-0229
Mailing address:
  • Phone: 570-823-1116
  • Fax: 570-812-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPP-413129-L
License Number StatePA

VIII. Authorized Official

Name: MR. JOSEPH THOMAS LIGOTSKI JR.
Title or Position: PRESIDENT
Credential: RPH
Phone: 570-823-1116