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General NPI Number Information
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NPI Number | 1518051085
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Entity Type | Organization
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Legal Business Name | JOHN R. SLAGLE
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 27 S MAIN ST
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City | SHEFFIELD
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State | PA
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Zip | 16347
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Country | US
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Telephone | 814-968-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 27 S MAIN ST
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City | SHEFFIELD
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State | PA
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Zip | 16347
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Country | US
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Telephone | 814-968-3636
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DANIEL CUSSINS
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Credential |
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Telephone | 814-968-3636
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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 | PP412268L
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License Number State | PA
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