Provider Demographics
NPI:1518965847
Name:HEALTH SYSTEMS & SOLUTIONS, INC.
Entity Type:Organization
Organization Name:HEALTH SYSTEMS & SOLUTIONS, INC.
Other - Org Name:DBA DUNMORE DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEBASTIANELLI
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:570-342-8427
Mailing Address - Street 1:702 N BLAKELY ST
Mailing Address - Street 2:UNIT #9
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-1963
Mailing Address - Country:US
Mailing Address - Phone:570-342-8427
Mailing Address - Fax:570-342-9748
Practice Address - Street 1:702 N BLAKELY ST
Practice Address - Street 2:UNIT #9
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1963
Practice Address - Country:US
Practice Address - Phone:570-342-8427
Practice Address - Fax:570-342-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001974080 0001 24Medicaid
PA4957920001Medicare ID - Type UnspecifiedRETAIL PHARMARY