Provider Demographics
NPI:1003531773
Name:JOHNSON'S PHARMACY OF CONYNGHAM, INC
Entity Type:Organization
Organization Name:JOHNSON'S PHARMACY OF CONYNGHAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-650-5639
Mailing Address - Street 1:345 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CONYNGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:18219
Mailing Address - Country:US
Mailing Address - Phone:570-650-5639
Mailing Address - Fax:
Practice Address - Street 1:345 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CONYNGHAM
Practice Address - State:PA
Practice Address - Zip Code:18219
Practice Address - Country:US
Practice Address - Phone:570-650-5639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy