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General NPI Number Information
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NPI Number | 1528015567
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Entity Type | Organization
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Legal Business Name | SUSQUEHANNA VENTURES, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 03/28/2011
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Provider Practice Location Address
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Address Line | 1201 GRAMPIAN BLVD DME SUITE
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1900
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Country | US
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Telephone | 570-320-7660
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Fax | 570-320-7659
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Provider Business Mailing Address
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Address Line | 1201 GRAMPIAN BLVD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1900
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Country | US
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Telephone | 570-320-7661
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Fax | 570-320-7667
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MS. PATRICIA A MCGEE
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Credential | MSN
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Telephone | 570-326-8920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PP413352L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PP413352L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PP413352L
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License Number State | PA
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