=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932264827
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHEMRX SALERNOS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2006
-----------------------------------------------------
Last Update Date | 02/26/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | BR 209 & BOSSARDSVILLE RD
-----------------------------------------------------
City | SCIOTA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-992-6300
-----------------------------------------------------
Fax | 570-402-2900
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 1 BOX 30
-----------------------------------------------------
City | SCIOTA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18354-9701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECT DIR
-----------------------------------------------------
Name | BARRY SCHEPP
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-409-5855
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336I0012X
-----------------------------------------------------
Taxonomy Name | Institutional Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number | PP415135L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------