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General NPI Number Information
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NPI Number | 1518339571
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Entity Type | Organization
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Legal Business Name | WELLSPAN PHARMACY INC
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Dates
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Enumeration Date | 10/29/2015
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 183 N READING RD STE 9 SUITE 9
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City | EPHRATA
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State | PA
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Zip | 17522-1647
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Country | US
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Telephone | 717-721-5784
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Fax | 717-733-0025
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Provider Business Mailing Address
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Address Line | PO BOX 20129
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City | YORK
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State | PA
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Zip | 17402-0140
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Country | US
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Telephone | 717-851-6903
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Fax | 717-851-5407
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Authorized Official
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Title or Position | SENIOR PHARMACY MANAGER
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Name | MR. KEVIN CHARNETSKI
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Credential | PHARM D
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Telephone | 570-262-6663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP482606
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License Number State | PA
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