Madjak Inc
Organization Active NPI Community/Retail Pharmacy · Old Forge, PA
NPI 1407900855 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1407900855
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PP415319L (PA)
- Legal business name
- MADJAK INC
- Practice address
- 730 S Main St
Old Forge, PA 18518-1459 - Phone
- (570) 457-3372
- Fax
- (570) 457-2679
- NPI assigned
- Jan 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Albert S Bilski Jr., RPH
- Title
- RPH
- Phone
- (570) 457-3372
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PP415319L | PA | Yes |
Addresses
Primary practice location
730 S Main St
Old Forge, PA 18518-1459
Mailing address
730 S Main St
Old Forge, PA 18518-1459
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016612640002 | Medicaid | PA | |
| 3973410 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- MEDICINE SHOPPE
Other providers in Old Forge, PA
- Victoria Lee
- Renee Lenceski
- Payton Lepore
- Allison Ann Lucarelli
- Caitlin Ashley Mackrell
- Marianne J. Santioni, D.O., PC
- Catherine Elizabeth Mars
- Shawn McNamara
- Megan L Merrick
- Michael a Jalowiec DO PC
All providers in Old Forge, 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 Mar 7, 2023. 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.