Winola Pharmacy

LBN: Wishbone Enterprises Llc
Winola Pharmacy is an health care organization with primary practice located at Route 307 Winola Plaza , Lake Winola PA 18625-2962. The organization recently has 3 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Wishbone Enterprises Llc can be contacted via phone (570) 378-2885, or through Konicki, Peter X via phone (570) 378-2885.

Contact Information

Primary practice address
Route 307 Winola Plaza Lake Winola PA 18625-2962
Phone: (570) 378-2885
Fax: (570) 378-2962
Website:
Map and Directions
Authorized official contact:
Name: Konicki, Peter X RPH
Phone: (570) 378-2885

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PP414435L Pennsylvania
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X RP032206L Pennsylvania
Suppliers / Community/Retail Pharmacy 3336C0003X PP414435L Pennsylvania

Profile Details

NPI number 1699781492
LBN Legal business name Wishbone Enterprises Llc
DBA Doing business as Winola Pharmacy
Authorized official Konicki, Peter X RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2006
Last updated May 15th, 2012 - about 12 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 1699781492 NPPES
Pennsylvania Other 3962330 NABP
Pennsylvania MEDICAID 1007440510001 NABP

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