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General NPI Number Information
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NPI Number | 1740348630
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Entity Type | Organization
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Legal Business Name | PLUMBS DRUG STORE CO
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 105 N ALLEGHENY ST
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City | BELLEFONTE
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State | PA
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Zip | 16823-1626
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Country | US
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Telephone | 814-355-3225
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Fax | 814-355-8547
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Provider Business Mailing Address
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Address Line | 105 N ALLEGHENY ST
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City | BELLEFONTE
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State | PA
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Zip | 16823-1626
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Country | US
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Telephone | 814-355-3225
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Fax | 814-355-8547
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Authorized Official
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Title or Position | OWNER
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Name | JOHN LUCKOVICH
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Credential | BS
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Telephone | 814-355-3225
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP411884L
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License Number State | PA
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