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General NPI Number Information
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NPI Number | 1568423390
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Entity Type | Organization
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Legal Business Name | ICP INC
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 175 CANAL ST
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City | SHARPSVILLE
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State | PA
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Zip | 16150
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Country | US
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Telephone | 888-203-8965
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Fax | 724-981-5029
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Provider Business Mailing Address
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Address Line | 175 CANAL ST
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City | SHARPSVILLE
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State | PA
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Zip | 16150-2236
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Country | US
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Telephone | 724-962-2056
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Fax | 724-962-2389
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | DANIEL JAMES SEIGHMAN
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Credential |
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Telephone | 216-310-2460
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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 | PP415164L
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License Number State | PA
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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 | PA
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State | PA
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