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General NPI Number Information
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NPI Number | 1366530057
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Entity Type | Organization
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Legal Business Name | PENBEC INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 34 N CONOCOCHEAGUE ST
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City | WILLIAMSPORT
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State | MD
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Zip | 21795-1004
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Country | US
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Telephone | 301-223-4103
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Fax | 301-223-4102
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Provider Business Mailing Address
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Address Line | 34 N CONOCOCHEAGUE ST
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City | WILLIAMSPORT
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State | MD
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Zip | 21795-1004
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Country | US
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Telephone | 301-223-4103
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Fax | 301-223-4102
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. JERRY P ALESHIRE
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Credential | RPH
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Telephone | 301-223-4103
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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 | PO2326
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License Number State | MD
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