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General NPI Number Information
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NPI Number | 1154702835
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Entity Type | Organization
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Legal Business Name | LEWISBURG PHARMACY
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 50 N 2ND ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1567
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Country | US
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Telephone | 570-768-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 50 N 2ND ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1567
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Country | US
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Telephone | 570-768-4446
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | BRADLEY W GILL
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Credential | PHARMD
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Telephone | 570-768-4446
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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 |
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License Number State |
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