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Provider Information for 1245302033


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LEPRI-RUANE INC

Other Names:  
Doing Business As: 
MEDICINE SHOPPE

Organization Subpart: NO

NPI: 1245302033
Last Updated: 2023-03-07
Certification Date:

Details

NameValue
NPI1245302033
Enumeration Date2006-11-15
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Dr. MARILYN RUANE Pharm.D
Title: Owner Pharmacist
Phone: 5703476575
Mailing Address 2239 PITTSTON AVE
SCRANTON, PA 18505-3237
United States

Phone: 570-347-6575 | Fax:570-963-7109
 
Primary Practice Address 2239 PITTSTON AVE
SCRANTON, PA 18505-3237
United States

Phone: 570-347-6575 | Fax:570-963-7109
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDPA0011026960001
Other (non-Medicare)3954662Other ID Number-Commercial Number
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy PAPP413974L
Yes 3336C0003X - Pharmacy - Community/Retail Pharmacy