Provider Demographics
NPI:1932269172
Name:MIKES PHARMACY
Entity type:Organization
Organization Name:MIKES PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZERBE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-628-3895
Mailing Address - Street 1:543 WEST FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:WOMELSDORF
Mailing Address - State:PA
Mailing Address - Zip Code:19567
Mailing Address - Country:US
Mailing Address - Phone:610-628-3895
Mailing Address - Fax:223-488-6250
Practice Address - Street 1:543 WEST FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:WOMELSDORF
Practice Address - State:PA
Practice Address - Zip Code:19567
Practice Address - Country:US
Practice Address - Phone:610-628-3895
Practice Address - Fax:223-488-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2082447OtherPK
PA0015283350001Medicaid