Provider Demographics
NPI:1447012232
Name:CORRY NATIONAL PHARMACY SYSTEMS, LLC
Entity type:Organization
Organization Name:CORRY NATIONAL PHARMACY SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:STANKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-656-4405
Mailing Address - Street 1:2501 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-1007
Mailing Address - Country:US
Mailing Address - Phone:814-656-4405
Mailing Address - Fax:
Practice Address - Street 1:2501 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-1007
Practice Address - Country:US
Practice Address - Phone:814-656-4405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service