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General NPI Number Information
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NPI Number | 1619988250
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Entity Type | Organization
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Legal Business Name | JAMES DRUG STORE
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 601 2ND ST
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City | CRESSON
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State | PA
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Zip | 16630-1226
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Country | US
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Telephone | 814-886-2266
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Fax | 814-886-6819
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Provider Business Mailing Address
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Address Line | 601 2ND ST
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City | CRESSON
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State | PA
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Zip | 16630-1226
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Country | US
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Telephone | 814-886-2266
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Fax | 814-886-6819
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Authorized Official
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Title or Position | OWNER AND PHARMACIST
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Name | DONALD DELLA
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Credential | RPH
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Telephone | 814-886-2266
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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 | PP411146L
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License Number State | PA
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