Provider Demographics
NPI:1124156450
Name:TWIN TIER MANAGEMENT CORP
Entity type:Organization
Organization Name:TWIN TIER MANAGEMENT CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:NESPOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-882-4317
Mailing Address - Street 1:7 COLONIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848
Mailing Address - Country:US
Mailing Address - Phone:570-265-0659
Mailing Address - Fax:570-265-0624
Practice Address - Street 1:7 COLONIAL DRIVE
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848
Practice Address - Country:US
Practice Address - Phone:570-265-0659
Practice Address - Fax:570-265-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-08-24
Deactivation Date:2009-07-07
Deactivation Code:
Reactivation Date:2009-08-24
Provider Licenses
StateLicense IDTaxonomies
PAPP4812723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0305220007Medicare NSC