Provider Demographics
NPI:1669555223
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:MR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SILBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-732-2112
Mailing Address - Street 1:2645 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-2001
Mailing Address - Country:US
Mailing Address - Phone:717-232-0400
Mailing Address - Fax:717-232-7590
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:2006-10-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
PAPP415659L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017986620001Medicaid
3977468OtherNCPDP
1317160001Medicare ID - Type Unspecified