Provider Demographics
NPI:1043395155
Name:EVANGELICAL COMMUNITY HOSPITAL PHARMACY AND HOMECARE PRODUCTS, INC.
Entity Type:Organization
Organization Name:EVANGELICAL COMMUNITY HOSPITAL PHARMACY AND HOMECARE PRODUCTS, INC.
Other - Org Name:HOMECARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-522-2000
Mailing Address - Street 1:1 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9314
Mailing Address - Country:US
Mailing Address - Phone:570-522-2579
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9314
Practice Address - Country:US
Practice Address - Phone:570-522-2579
Practice Address - Fax:570-522-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PAPP413804L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007786860001Medicaid
PA3951591OtherNABP
PA1007786860001Medicaid