Provider Demographics
NPI:1477107043
Name:GDD PHARMACY SERVICES INC
Entity type:Organization
Organization Name:GDD PHARMACY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-732-2112
Mailing Address - Street 1:1300 BENT CREEK BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-1874
Mailing Address - Country:US
Mailing Address - Phone:717-732-2112
Mailing Address - Fax:717-732-2116
Practice Address - Street 1:2645 N 3RD ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-2001
Practice Address - Country:US
Practice Address - Phone:717-232-0400
Practice Address - Fax:717-232-7590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017986620001Medicaid