Provider Demographics
NPI:1952316598
Name:LAUREL DRUGS INC
Entity Type:Organization
Organization Name:LAUREL DRUGS INC
Other - Org Name:HEALTHLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZABELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-626-1988
Mailing Address - Street 1:601 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-2635
Mailing Address - Country:US
Mailing Address - Phone:724-628-1100
Mailing Address - Fax:724-626-5970
Practice Address - Street 1:601 YORK AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-2635
Practice Address - Country:US
Practice Address - Phone:724-628-1100
Practice Address - Fax:724-626-5970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP413137L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005677780003Medicaid
3906748OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PA0005677780003Medicaid