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General NPI Number Information
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NPI Number | 1447397443
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Entity Type | Organization
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Legal Business Name | MECHANICSBURG DRUGGIST LLC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 26 S MAIN ST
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City | MECHANICSBURG
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State | OH
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Zip | 43044-1111
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Country | US
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Telephone | 937-834-2270
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Fax | 937-834-3906
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | PLAIN CITY
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State | OH
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Zip | 43064-0126
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Country | US
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Telephone | 614-573-1557
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Fax | 614-300-7558
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LONNIE J CRAFT
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Credential | RPH
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Telephone | 614-573-1557
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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 | 020394900
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License Number State | OH
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