Provider Demographics
NPI:1497235196
Name:MINNICH'S PHARMACY INC
Entity Type:Organization
Organization Name:MINNICH'S PHARMACY INC
Other - Org Name:MINNICH'S CONTINUING CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-848-2311
Mailing Address - Street 1:974 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3708
Mailing Address - Country:US
Mailing Address - Phone:717-848-2312
Mailing Address - Fax:717-854-9501
Practice Address - Street 1:974 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3708
Practice Address - Country:US
Practice Address - Phone:717-848-2311
Practice Address - Fax:877-563-1477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINNICHS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-21
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD554816101Medicaid
6006995OtherNCPDP
PA0012134610004Medicaid