MEDICARE: PENN LAUREL PHARMACY, LLC.

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	3336C0003X	Community/Retail Pharmacy		PA

General Provider Information

NPI Number	:	1891804951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENN LAUREL PHARMACY, LLC.

Provider Business Mailing Address
First Line	:	112 SUNSHINE AVE
Second Line	:
City	:	CENTRAL CITY
State	:	PA
Zip	:	15926-1129
Country	:	US
Telephone Number	:	814-754-5717
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 SUNSHINE AVE
Second Line	:
City	:	CENTRAL CITY
State	:	PA
Zip	:	15926-1129
Country	:	US
Telephone Number	:	814-754-5717
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	JACQUELINE MARTELLA M MARTELLA
Credential	:
Telephone Number	:	814-754-5717

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/30/2020

Similar Medicare Providers

1992846125 — CENTRAL CITY FIRE DEPARTMENT
Practice Location Address:

241 SUNSHINE AVE
CENTRAL CITY, PA
15926-1164

Practice Phone: 814-754-5111
Practice Fax:

1205093119 — DR. FORREST A. SCHUCKER M.D.,PH.D.
Practice Location Address:

433 PENINSULA DR
CENTRAL CITY, PA
15926-9360

Practice Phone: 814-754-5814
Practice Fax:

1013155076 — JEFFREY ANDREW FERKO CRNA
Practice Location Address:

136 MEADOW AVE
CENTRAL CITY, PA
15926-1243

Practice Phone: 814-754-4006
Practice Fax:

1679855217 — DR. ROBERT ALBERT WINTER III PHARMD
Practice Location Address:

2931 CENTRAL CITY BLVD
GALVESTON, TX
77551-1129

Practice Phone: 409-740-2488
Practice Fax: 409-740-8320

1356112080 — 1918 WINTER STREET OPERATING CO LLC
Practice Location Address:

2931 CENTRAL CITY BLVD
GALVESTON, TX
77551-1129

Practice Phone: 409-740-2488
Practice Fax: 409-740-8320

1881459394 — VRAJESH RAJESH KANCHANWALA
Practice Location Address:

2931 CENTRAL CITY BLVD
GALVESTON, TX
77551-1129

Practice Phone: 409-740-2488
Practice Fax: 409-740-8320

Directions to “PENN LAUREL PHARMACY, LLC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.