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General NPI Number Information
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NPI Number | 1568434751
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Entity Type | Organization
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Legal Business Name | POPS DRUGSTORE INC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 1547 ROUTE 507
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City | GREENTOWN
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State | PA
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Zip | 18426-4506
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Country | US
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Telephone | 570-676-0012
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Fax |
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Provider Business Mailing Address
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Address Line | 1547 ROUTE 507
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City | GREENTOWN
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State | PA
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Zip | 18426-4506
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Country | US
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Telephone | 570-676-0012
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | ROSS P. REICHMAN
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Credential |
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Telephone | 570-676-0012
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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 | PP481484
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License Number State | PA
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