Provider Demographics
NPI:1033455720
Name:PLUMBS DRUG STORE CO.
Entity Type:Organization
Organization Name:PLUMBS DRUG STORE CO.
Other - Org Name:PLUMBS DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LUCKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:814-355-3225
Mailing Address - Street 1:105 N ALLEGHENY ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1626
Mailing Address - Country:US
Mailing Address - Phone:814-355-3225
Mailing Address - Fax:814-355-8547
Practice Address - Street 1:105 N ALLEGHENY ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1626
Practice Address - Country:US
Practice Address - Phone:814-355-3225
Practice Address - Fax:814-355-8547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411884L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy