Medicap Pharmacy

LBN: East Lake Pharmacy Inc
Medicap Pharmacy is an health care organization with primary practice located at 1896 E Lake Rd , Erie PA 16511-1072. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. East Lake Pharmacy Inc can be contacted via phone (814) 456-4108, or through Kosobucki, Richard J via phone (814) 456-4108.

Contact Information

Primary practice address
1896 E Lake Rd Erie PA 16511-1072
Phone: (814) 456-4108
Fax: (814) 456-4417
Website:
Map and Directions
Authorized official contact:
Name: Kosobucki, Richard J RPH
Phone: (814) 456-4108

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PP481227 Pennsylvania

Profile Details

NPI number 1326151432
LBN Legal business name East Lake Pharmacy Inc
DBA Doing business as Medicap Pharmacy
Authorized official Kosobucki, Richard J RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326151432 NPPES
Pennsylvania Other 3981479 NCPDP #
Pennsylvania MEDICAID 0019341830001 NCPDP #

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