Provider Demographics
NPI:1043322480
Name:SLOAN'S PHARMACY, INC
Entity Type:Organization
Organization Name:SLOAN'S PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:N
Authorized Official - Last Name:KAUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-653-4001
Mailing Address - Street 1:61 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552-1424
Mailing Address - Country:US
Mailing Address - Phone:717-653-4001
Mailing Address - Fax:717-653-1247
Practice Address - Street 1:61 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-1424
Practice Address - Country:US
Practice Address - Phone:717-653-4001
Practice Address - Fax:717-653-1247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP412313L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007569740004Medicaid
PAPP412313LOtherSTATE LICENSE
PA3900431OtherNCPDP
PA3900431OtherNCPDP