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General NPI Number Information
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NPI Number | 1043460405
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Entity Type | Organization
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Legal Business Name | REDDON DRUG CO. INC.
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 177 ERIE BLVD
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City | SUSQUEHANNA
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State | PA
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Zip | 18847
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Country | US
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Telephone | 570-853-4172
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Fax | 570-853-3892
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Provider Business Mailing Address
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Address Line | 177 ERIE BLVD
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City | SUSQUEHANNA
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State | PA
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Zip | 18847
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Country | US
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Telephone | 570-853-4172
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Fax | 570-853-3892
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Authorized Official
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Title or Position | OWNER
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Name | MISS KATHLEEN REDDON
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Credential |
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Telephone | 570-853-4172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP412034L
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License Number State | PA
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