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General NPI Number Information
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NPI Number | 1457870081
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Entity Type | Organization
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Legal Business Name | SAEGERTOWN PHARMACY
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Dates
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Enumeration Date | 09/14/2017
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 201 MAIN ST SAEGERTOWN PLAZA
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City | SAEGERTOWN
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State | PA
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Zip | 16433-7617
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Country | US
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Telephone | 814-763-1107
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Fax | 814-763-1103
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Provider Business Mailing Address
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Address Line | 201 MAIN ST
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City | SAEGERTOWN
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State | PA
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Zip | 16433-7617
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Country | US
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Telephone | 814-763-1103
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Fax | 814-763-1107
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Authorized Official
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Title or Position | PHARMACIST
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Name | ROBERT SWEENEY
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Credential | PHARMACY
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Telephone | 814-573-7161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482778
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License Number State | PA
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