Provider Demographics
NPI:1649857137
Name:PRESCRIPTION CENTER- SOUTH WASHINGTON INC
Entity type:Organization
Organization Name:PRESCRIPTION CENTER- SOUTH WASHINGTON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUANE
Authorized Official - Suffix:II
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:570-614-3431
Mailing Address - Street 1:1303 VERNE CLOSE
Mailing Address - Street 2:
Mailing Address - City:MOOSIC
Mailing Address - State:PA
Mailing Address - Zip Code:18507-2214
Mailing Address - Country:US
Mailing Address - Phone:570-343-2448
Mailing Address - Fax:
Practice Address - Street 1:329 CHERRY ST STE 1A
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1505
Practice Address - Country:US
Practice Address - Phone:272-228-1725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy