Edward S. Wilcox
Organization Active NPI Community/Retail Pharmacy · Republic, PA
NPI 1073678850 · NPPES record last updated Aug 25, 2010
Key facts
- NPI
- 1073678850
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PP411751L (PA)
- Legal business name
- EDWARD S. WILCOX
- Practice address
- 1009 Main St
Republic, PA 15475 - Phone
- (724) 246-8800
- Fax
- (724) 246-5050
- NPI assigned
- Dec 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Edward S Wilcox, RPH
- Title
- Owner Pharmacist
- Phone
- (724) 246-8800
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | PP411751L | PA | |
| Pharmacy | 333600000X | PP411751L | PA | |
| Community/Retail Pharmacy | 3336C0003X | PP411751L | PA | Yes |
Addresses
Primary practice location
1009 Main St
Republic, PA 15475
Mailing address
1009 Main St
Republic, PA 15475
Phone (724) 246-8800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000563349 | Medicaid | PA |
Other names
- Redstone Pharmacy
Other providers in Republic, PA
- Centerville Clinics, Inc.
- Centerville Clinics, Inc.
- Bryan A Ferro
- Jennifer Kovach
- Aaron Lenhart
- Ingrid K Toothman
All providers in Republic, PA · Community/Retail Pharmacy in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.