Provider Demographics
NPI:1265450647
Name:SALERNO PHARMACY LLC
Entity Type:Organization
Organization Name:SALERNO PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-992-6300
Mailing Address - Street 1:HC1 BOX30
Mailing Address - Street 2:RT 209 AND BOSSARDSVILLE RD
Mailing Address - City:SCIOTA
Mailing Address - State:PA
Mailing Address - Zip Code:18354
Mailing Address - Country:US
Mailing Address - Phone:570-992-6300
Mailing Address - Fax:570-402-5000
Practice Address - Street 1:HC1 BOX30
Practice Address - Street 2:RT 209 AND BOSSARDSVILLE RD
Practice Address - City:SCIOTA
Practice Address - State:PA
Practice Address - Zip Code:18354
Practice Address - Country:US
Practice Address - Phone:570-992-6300
Practice Address - Fax:570-402-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415135L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3973559OtherNABP#