Provider Demographics
NPI:1235782707
Name:MILLERSBURG PHARMACY, INC.,LTC
Entity Type:Organization
Organization Name:MILLERSBURG PHARMACY, INC.,LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MCALANIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:717-692-3620
Mailing Address - Street 1:242 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17061-1334
Mailing Address - Country:US
Mailing Address - Phone:717-692-2161
Mailing Address - Fax:
Practice Address - Street 1:242 MARKET ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17061-1334
Practice Address - Country:US
Practice Address - Phone:717-692-2161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007783180006Medicaid