Provider Demographics
NPI:1659320547
Name:WILCOX DRUGS INC.
Entity Type:Organization
Organization Name:WILCOX DRUGS INC.
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-274-1500
Mailing Address - Street 1:1305 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-4529
Mailing Address - Country:US
Mailing Address - Phone:717-274-1500
Mailing Address - Fax:717-274-2583
Practice Address - Street 1:1305 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-4529
Practice Address - Country:US
Practice Address - Phone:717-274-1500
Practice Address - Fax:717-274-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413769L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3950979OtherNCPDP #
PA1066713Medicaid
PA1066713Medicaid
PA1066713Medicaid
PA140387Medicare PIN