Provider Demographics
NPI:1255396396
Name:ALBION PHARMACY INC
Entity type:Organization
Organization Name:ALBION PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:DREHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:814-756-3429
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:EMLENTON
Mailing Address - State:PA
Mailing Address - Zip Code:16373-0010
Mailing Address - Country:US
Mailing Address - Phone:814-756-3429
Mailing Address - Fax:814-756-5882
Practice Address - Street 1:9 EAST STATE ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:PA
Practice Address - Zip Code:16401-1110
Practice Address - Country:US
Practice Address - Phone:814-756-3429
Practice Address - Fax:814-756-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP410032LOtherPHARMACY LICENSE
PA0005677400001Medicaid
3913565OtherNCPDP