Provider Demographics
NPI:1427191584
Name:SMITHGALL BROS CO PHARMACY
Entity Type:Organization
Organization Name:SMITHGALL BROS CO PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHGALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-397-6218
Mailing Address - Street 1:714 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3635
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:714 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3635
Practice Address - Country:US
Practice Address - Phone:717-397-3688
Practice Address - Fax:717-295-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410655L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3955462OtherOTHER ID NUMBER
3955462OtherOTHER ID NUMBER-COMMERCIAL NUMBER