Old Roswell Holdings LLC
Pharmacy, Long Term Care Pharmacy in Mechanicsburg, PA. Organization (NPI-2).
NPI number1669285151
StatusActive
Last updated in NPPESApr 23, 2025
Details
- NPI
- 1669285151
- Entity type
- Organization (NPI-2)
- Legal business name
- Old Roswell Holdings LLC
- Organization subpart
- No
- Enumeration date
- Jan 29, 2025
- Certification date
- Apr 23, 2025
- Last updated
- Apr 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Medicine Shoppe 2009 (Doing Business As)
Practice location
5225 Wilson LnMechanicsburg, PA 17055-6663
Phone 717-516-3103 · Fax 717-516-3104
Mailing address
5064 Roswell Rd Ste A200Atlanta, GA 30342-2252
Phone 404-459-8005 · Fax 404-256-5517
Authorized official
Tracy Eden
Owner
4044598005
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