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General NPI Number Information
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NPI Number | 1598856411
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Entity Type | Organization
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Legal Business Name | EVERLONG PHARMACY, L.L.P.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 99 N CHURCH ST
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City | CARBONDALE
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State | PA
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Zip | 18407-2148
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Country | US
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Telephone | 570-281-6141
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Fax | 570-281-3903
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Provider Business Mailing Address
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Address Line | 99 N CHURCH ST
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City | CARBONDALE
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State | PA
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Zip | 18407-2148
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Country | US
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Telephone | 570-281-6141
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Fax | 570-281-3903
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DINA BANAS
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Credential | RPH
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Telephone | 570-281-6141
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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 | PP415529L
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License Number State | PA
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