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General NPI Number Information
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NPI Number | 1467551333
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Entity Type | Organization
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Legal Business Name | MILLSBORO PHARMACY INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 321 OLD LANDING ROAD
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City | MILLSBORO
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State | DE
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Zip | 19966
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Country | US
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Telephone | 302-934-9398
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Fax | 302-934-9398
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Provider Business Mailing Address
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Address Line | PO BOX 516
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City | MILLSBORO
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State | DE
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Zip | 19966-0516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WALTER DOLAN
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Credential |
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Telephone | 302-934-9398
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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 | A30000438
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License Number State | DE
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