Wishbone Enterprises LLC
NPI #1699781492 in Lake Winola, Pennsylvania
Provider Information
- NPI Number
- 1699781492
- Entity Type
- Organization
- Organization Name
- Wishbone Enterprises LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Aug 1, 2006
- Last Updated
- May 15, 2012
Practice Location
- Address
- ROUTE 307 WINOLA PLAZA
- City
- Lake Winola
- State
- Pennsylvania
- ZIP Code
- 18625-2962
- Phone
- (570) 378-2885
Authorized Official
- Name
- MR. PETER X KONICKI, RPH
- Title
- PHARMACY OWNER
- Phone
- (570) 378-2885
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
| Durable Medical Equipment & Medical Supplies |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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