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General NPI Number Information
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NPI Number | 1497790612
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Entity Type | Organization
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Legal Business Name | PRESCRIPTIONS PLUS OF CONNELLSVILLE INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 2618 MEMORIAL BLVD STE A
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-1419
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Country | US
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Telephone | 724-628-7500
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Fax | 724-628-7550
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Provider Business Mailing Address
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Address Line | 2618 MEMORIAL BLVD STE A
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-1419
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Country | US
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Telephone | 724-628-7500
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Fax | 724-628-7550
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Authorized Official
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Title or Position | OWNER
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Name | TIM MUCCINO
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Credential |
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Telephone | 724-628-7500
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP415760L
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License Number State | PA
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