Provider Demographics
NPI:1740398817
Name:CL CRESSLER INC
Entity Type:Organization
Organization Name:CL CRESSLER INC
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMS
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CRAIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-232-9490
Mailing Address - Street 1:1800 LINGLESTOWN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3347
Mailing Address - Country:US
Mailing Address - Phone:717-232-9490
Mailing Address - Fax:717-232-5909
Practice Address - Street 1:100 RANO BLVD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-2798
Practice Address - Country:US
Practice Address - Phone:607-798-8878
Practice Address - Fax:607-798-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024753333600000X
NY3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02728783Medicaid
NY3327788OtherNCPDP #
NYBC9593802OtherDEA #
NY02728783Medicaid