Doris Ella Seasholtz

Individual provider Active NPI Pharmacist · Northumberland, PA

NPI 1710117643 · NPPES record last updated Jul 27, 2009

Key facts

NPI
1710117643
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RP038166L (PA)
Practice address
Route 11
Synergy Grandview Pharmacy Inc
Northumberland, PA 17857
Phone
(570) 473-7506
Fax
(570) 473-9336
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RP038166LPAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP038166L PA Yes

Addresses

Primary practice location

Route 11
Synergy Grandview Pharmacy Inc
Northumberland, PA 17857

Mailing address

99 George LN
Selinsgrove, PA 17870-8110
Phone (570) 884-9600

Other names

  • Miss Doris Ella Clark Former name

Other providers in Northumberland, PA

All providers in Northumberland, PA · Pharmacist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.