Provider Demographics
NPI:1356343800
Name:MILLERSBURG PHARMACY, INC.
Entity type:Organization
Organization Name:MILLERSBURG PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MCALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-692-2161
Mailing Address - Street 1:242 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17061-1334
Mailing Address - Country:US
Mailing Address - Phone:717-692-2161
Mailing Address - Fax:717-692-2162
Practice Address - Street 1:242 MARKET ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17061-1334
Practice Address - Country:US
Practice Address - Phone:717-692-2161
Practice Address - Fax:717-692-2162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP 028112L183500000X
332B00000X, 333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007783180006Medicaid
PA3947580OtherNABP NUMBER
PA1007783180006Medicaid
PA0218900001Medicare ID - Type UnspecifiedREGION A PROVIDER NUMBER