National Provider Identifier Database

MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA
Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.


Contact Information

MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA
1 MASONIC DR
ELIZABETHTOWN, PA17022-2199
Phone: 717-367-1121
Fax: 717-367-5813
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X
Institutional Pharmacy 3336I0012X

* Indicates primary specialty

NPI Profile & details for MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA

NPI Number 1659625580
Legal business name
LBN
MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA
Authorized official PAMELA FORMICA - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart No
Enumeration date 10/30/2012
Last updated 03/03/2026 - About 3 months ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: HP416534L
  • Other: 3998741 NCPDP
  • PA Other: HP416534L PHARMACY LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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