Provider Demographics
NPI:1760199590
Name:GAUGHNS DRUG STORE
Entity Type:Organization
Organization Name:GAUGHNS DRUG STORE
Other - Org Name:GAUGHNS DRUG STORE - LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:814-723-2840
Mailing Address - Street 1:348 PENNSYLVANIA AVE W
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2424
Mailing Address - Country:US
Mailing Address - Phone:814-723-2840
Mailing Address - Fax:
Practice Address - Street 1:348 PENNSYLVANIA AVE W
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2424
Practice Address - Country:US
Practice Address - Phone:814-723-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GAUGHNS DRUG STORE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy