BROAD AVENUE PHARMACY LLC
2329 Broad Ave
Altoona, PA 16601
814-943-1310
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 333600000X | Suppliers - Pharmacy - | ||
Y | 3336C0003X | Suppliers - Pharmacy | PA | PP410249L |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0019655640001 | PA | MEDICAID | |
PK | 2086603 | OTHER |