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General NPI Number Information
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NPI Number | 1629133046
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Entity Type | Organization
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Legal Business Name | BROCKIE HEALTHCARE INC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 100 HOMEWOOD WAY
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City | HANOVER
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State | PA
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Zip | 17331-7860
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Country | US
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Telephone | 717-632-5000
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Fax | 717-637-5020
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Provider Business Mailing Address
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Address Line | 100 HOMEWOOD WAY
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City | HANOVER
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State | PA
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Zip | 17331-7860
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Country | US
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Telephone | 717-632-5000
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Fax | 717-637-5020
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Authorized Official
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Title or Position | VP OF OPR
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Name | ERIC SHELLEY
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Credential | RPH
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Telephone | 717-848-3445
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PP481482
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License Number State | PA
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