=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700185808
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. TRENLEY MARTIN ARMSTRONG
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2011
-----------------------------------------------------
Last Update Date | 03/15/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7036 WERTZVILLE RD
-----------------------------------------------------
City | MECHANICSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17050-1542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-697-3450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 TAVERN HOUSE HL
-----------------------------------------------------
City | MECHANICSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17050-4100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-766-1684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP441490
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------