Provider Demographics
NPI:1356192512
Name:SPAN & TAYLOR DRUG CO
Entity type:Organization
Organization Name:SPAN & TAYLOR DRUG CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MARCHEWKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-258-4545
Mailing Address - Street 1:175 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-2305
Mailing Address - Country:US
Mailing Address - Phone:724-258-4545
Mailing Address - Fax:724-258-7909
Practice Address - Street 1:175 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2305
Practice Address - Country:US
Practice Address - Phone:724-258-4545
Practice Address - Fax:724-258-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy