Provider Demographics
NPI:1508446212
Name:TERRANOVA RX
Entity Type:Organization
Organization Name:TERRANOVA RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WISNIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-336-2292
Mailing Address - Street 1:2590 N READING RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:PA
Mailing Address - Zip Code:17517-9153
Mailing Address - Country:US
Mailing Address - Phone:717-484-2649
Mailing Address - Fax:
Practice Address - Street 1:2590 N READING RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:PA
Practice Address - Zip Code:17517-9153
Practice Address - Country:US
Practice Address - Phone:717-484-2649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy