Landon Scott Bordner, PHARMD, MBA
Individual provider Active NPI Pharmacist · Elizabethville, PA
NPI 1740913730 · NPPES record last updated Jul 6, 2022
Key facts
- NPI
- 1740913730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP456782 (PA)
- Practice address
- 4686 State Route 209
Elizabethville, PA 17023-8478 - Phone
- (717) 362-9018
- Fax
- (717) 362-4014
- NPI assigned
- Jul 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP456782 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past |
Accepting new patients | |
| Pennsylvania CVS Pharmacy, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP456782 | PA | Yes |
Addresses
Primary practice location
4686 State Route 209
Elizabethville, PA 17023-8478
Mailing address
213 Dayton St
Williamstown, PA 17098-9513
Phone (717) 350-0131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PII000090 | Other | PA | AUTHORIZATION TO ADMINISTER INJECTABLES |
| RP456782 | Other | PA | REGISTERED PHARMACIST |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | unknown |
Other providers in Elizabethville, PA
- Danielle Marie Avery
- Sonya L Barge
- Bellis Chiropractic, Inc.
- Brett A Bellis
- Krista Bond
- Nichole Anne Campbell
- David R Russell Dmdpc, Dba'Rising Sun Dental Care'
- Edgewater Psychiatric Center
- Michelle Maureen Haszto
- Molly Heckard
All providers in Elizabethville, PA · Pharmacist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2022. 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.