Provider Demographics
NPI:1174706493
Name:MILLERSBURG PHARMACY DBA DALHERN PHARMACY
Entity type:Organization
Organization Name:MILLERSBURG PHARMACY DBA DALHERN PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MCALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:717-692-2161
Mailing Address - Street 1:4372 STATE ROUTE 147
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:PA
Mailing Address - Zip Code:17830-7439
Mailing Address - Country:US
Mailing Address - Phone:570-758-2042
Mailing Address - Fax:570-758-5486
Practice Address - Street 1:4372 STATE ROUTE 147
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:PA
Practice Address - Zip Code:17830-7439
Practice Address - Country:US
Practice Address - Phone:570-758-2042
Practice Address - Fax:570-758-5486
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLERSBURG PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-10
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414150L332B00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0218900002Medicare UPIN