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General NPI Number Information
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NPI Number | 1477579894
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Entity Type | Organization
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Legal Business Name | BAYERS PHARMACY
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 1 N 4TH ST
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City | YOUNGWOOD
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State | PA
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Zip | 15697-1305
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Country | US
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Telephone | 814-754-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 168 S PENINSULA DR
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City | CENTRAL CITY
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State | PA
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Zip | 15926-9206
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Country | US
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Telephone | 814-754-8250
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN THOMAS LYPSON
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Credential | PHARMACIST
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Telephone | 814-754-8250
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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 | PP-410132-L
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License Number State | PA
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