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General NPI Number Information
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NPI Number | 1003304379
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Entity Type | Organization
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Legal Business Name | MARTELLA'S LTC MEDIPAC SERVICES LLC
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 1079 FRANKLIN ST SUITE 2
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City | JOHNSTOWN
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State | PA
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Zip | 15905
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Country | US
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Telephone | 814-535-5949
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Fax | 814-539-2234
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Provider Business Mailing Address
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Address Line | 1079 FRANKLIN ST SUITE 2
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City | JOHNSTOWN
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State | PA
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Zip | 15905
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Country | US
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Telephone | 814-535-5949
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Fax | 814-539-2234
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Authorized Official
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Title or Position | PARTNER
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Name | MR. JOSEPH MICHAEL MARTELLA JR.
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Credential | R.PH.
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Telephone | 814-535-1833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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