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General NPI Number Information
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NPI Number | 1265792048
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Entity Type | Organization
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Legal Business Name | COATESVILLE PHARMACY
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 270 E LINCOLN HWY
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City | COATESVILLE
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State | PA
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Zip | 19320-3408
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Country | US
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Telephone | 610-380-8520
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Fax | 610-380-8530
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Provider Business Mailing Address
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Address Line | 270 E LINCOLN HWY
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City | COATESVILLE
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State | PA
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Zip | 19320-3408
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Country | US
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Telephone | 610-380-8520
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Fax | 610-380-8530
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VENKAT GUNDAPUNENI
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Credential | VG
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Telephone | 302-339-0130
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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 | PP482277
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License Number State | PA
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