Sulco RX, LLC
Organization Active NPI Community/Retail Pharmacy · Dushore, PA
NPI 1790790392 · NPPES record last updated Feb 5, 2026
Key facts
- NPI
- 1790790392
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PP413412L (PA)
- Legal business name
- SULCO RX, LLC
- Practice address
- 220 S German St
Dushore, PA 18614-7891 - Phone
- (570) 928-8010
- Fax
- (570) 928-7036
- NPI assigned
- Jul 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Melissa Keller
- Title
- Owner
- Phone
- (570) 244-8674
Corporate family (same tax ID) 1
Practitioners 1
-
Melissa Keller, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230817003874 | PA | Part B Supplier - Pharmacy | 5890157168 | Practice locations: Dushore, PA |
| O20240206004032 | PA | DME Supplier - Pharmacy | 5890157168 | Practice locations: Dushore, PA |
National Provider Directory
- Tax ID family
- Dushore Pharmacy
Locations
220 S German St
Dushore, PA 18614
Phone (570) 928-8010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PP413412L | PA | Yes |
Addresses
Primary practice location
220 S German St
Dushore, PA 18614-7891
Mailing address
PO Box 314
Dushore, PA 18614-0314
Phone (570) 928-8010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2081283 | Other | PK | |
| 1042121750001 | Medicaid | PA |
Other names
- DUSHORE PHARMACY
Other providers in Dushore, PA
All providers in Dushore, 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 Feb 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.