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General NPI Number Information
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NPI Number | 1043423171
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH OF PENNSYLVANIA
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 1001 STERIGERE ST
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City | NORRISTOWN
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State | PA
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Zip | 19401-5300
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Country | US
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Telephone | 610-313-5867
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 STERIGERE ST
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City | NORRISTOWN
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State | PA
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Zip | 19401-5300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATTI A. EISNER
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Credential |
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Telephone | 717-705-2774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | HP417021L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | HP417021L
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License Number State | PA
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