Provider Demographics
NPI:1962979708
Name:NOCKLEY FAMILY PHARMACY INC
Entity type:Organization
Organization Name:NOCKLEY FAMILY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NOCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:570-208-5500
Mailing Address - Street 1:1150 S MAIN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18504-2956
Mailing Address - Country:US
Mailing Address - Phone:570-207-1318
Mailing Address - Fax:
Practice Address - Street 1:1150 S MAIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18504-2956
Practice Address - Country:US
Practice Address - Phone:570-207-1318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOCKLEY FAMILY PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-30
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy