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NPI Code Detail

MEDICARE: COLES PHARMACY

MEDICARE: COLES PHARMACY
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
13336C0003XCommunity/Retail PharmacyPP410435LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23919341OTHERNCPDP

General Provider Information

NPI Number : 1205922457
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLES PHARMACY
Provider Business Mailing Address
First Line : 2 S MAIN STREET
Second Line :
City : MANSFIELD
State : PA
Zip : 16933-1508
Country : US
Telephone Number : 570-662-2351
Fax Number : 570-662-3738
Provider Business Practice Location Address
First Line : 2 S MAIN STREET
Second Line :
City : MANSFIELD
State : PA
Zip : 16933-1508
Country : US
Telephone Number : 570-662-2351
Fax Number : 570-662-3738
Authorized Official
Title or Position : OWNER RPH
Name : MR. ROBERT GEORGE STRONG
Credential : RPH
Telephone Number : 570-662-2351
Provider Enumeration Date : 10/05/2006
Last Update Date : 02/04/2008

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Directions to “COLES PHARMACY ” Practice Location

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