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General NPI Number Information
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NPI Number | 1679565741
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Entity Type | Organization
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Legal Business Name | JOHN R SLAGLE
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 100 LIBERTY ST
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City | CLARION
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State | PA
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Zip | 16214-1808
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Country | US
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Telephone | 814-226-9310
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Fax | 814-226-9329
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Provider Business Mailing Address
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Address Line | 100 LIBERTY ST
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City | CLARION
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State | PA
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Zip | 16214-1808
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Country | US
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Telephone | 814-226-9310
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Fax | 814-226-9329
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Authorized Official
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Title or Position | OWNER
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Name | JOHN SLAGLE
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Credential | RPH
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Telephone | 814-226-9310
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP414620L
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License Number State | PA
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