Provider Demographics
NPI:1033252523
Name:STERLING PHARMACY,INC.
Entity Type:Organization
Organization Name:STERLING PHARMACY,INC.
Other - Org Name:STERLING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-876-4412
Mailing Address - Street 1:547 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JERMYN
Mailing Address - State:PA
Mailing Address - Zip Code:18433-1610
Mailing Address - Country:US
Mailing Address - Phone:570-876-4412
Mailing Address - Fax:570-876-4413
Practice Address - Street 1:547 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JERMYN
Practice Address - State:PA
Practice Address - Zip Code:18433
Practice Address - Country:US
Practice Address - Phone:570-876-4412
Practice Address - Fax:570-876-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410957L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001072470-0001Medicaid