MEDICARE: FRED B APPLEBY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP410070L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2081354	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174534747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRED B APPLEBY INC

Provider Business Mailing Address
First Line	:	133 E SHIRLEY ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1625
Country	:	US
Telephone Number	:	814-542-4412
Fax Number	:	814-542-2960

Provider Business Practice Location Address
First Line	:	133 E SHIRLEY ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1625
Country	:	US
Telephone Number	:	814-542-4412
Fax Number	:	814-542-2960

Authorized Official
Title or Position	:	PHMCT OWNER
Name	:	TROY PARSONS
Credential	:	RPH
Telephone Number	:	814-542-4412

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	10/18/2023

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Directions to “FRED B APPLEBY INC ” Practice Location

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