Provider Demographics
NPI:1790911600
Name:KRAHLING LLC
Entity Type:Organization
Organization Name:KRAHLING LLC
Other - Org Name:PENNS VALLEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-422-8911
Mailing Address - Street 1:4576 PENNS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16875-8500
Mailing Address - Country:US
Mailing Address - Phone:814-422-8911
Mailing Address - Fax:814-422-8368
Practice Address - Street 1:4576 PENNS VALLEY RD
Practice Address - Street 2:
Practice Address - City:SPRING MILLS
Practice Address - State:PA
Practice Address - Zip Code:16875-8500
Practice Address - Country:US
Practice Address - Phone:814-422-8911
Practice Address - Fax:814-422-8368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP412431L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023110200001Medicaid
3992181OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6280320001Medicare NSC