Provider Demographics
NPI:1043460405
Name:REDDON DRUG CO. INC.
Entity type:Organization
Organization Name:REDDON DRUG CO. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-853-4172
Mailing Address - Street 1:177 ERIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SUSQUEHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18847
Mailing Address - Country:US
Mailing Address - Phone:570-853-4172
Mailing Address - Fax:570-853-3892
Practice Address - Street 1:177 ERIE BLVD
Practice Address - Street 2:
Practice Address - City:SUSQUEHANNA
Practice Address - State:PA
Practice Address - Zip Code:18847
Practice Address - Country:US
Practice Address - Phone:570-853-4172
Practice Address - Fax:570-853-3892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP412034L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy