Wishbone Enterprises Llc
Community/Retail Pharmacy
Route 307 Winola Plaza, Lake Winola
Pennsylvania, 18625-2962
570-378-2885 570-378-2962
Wishbone Enterprises Llc is a Community/Retail Pharmacy in Lake Winola, Pennsylvania. It is located at Route 307 Winola Plaza, Lake Winola and it's customer support contact number is 570-378-2885. The authorized person of Wishbone Enterprises Llc is Mr. Peter X Konicki, RPH who is Pharmacy Owner of the pharmacy and his contact number is 570-378-2885. Active license number of Wishbone Enterprises Llc is PP414435L for Community/Retail Pharmacy in Pennsylvania. Wishbone Enterprises Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Wishbone Enterprises Llc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Wishbone Enterprises Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Wishbone Enterprises Llc |
| Type: | Community/Retail Pharmacy |
| Location: | Route 307 Winola Plaza, Lake Winola,
Pennsylvania, 18625-2962 |
| Phone: | 570-378-2885 |
| Fax: | 570-378-2962 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Peter X Konicki |
| Credentials: | RPH |
| Position: | Pharmacy Owner |
| Contact Number: | 570-378-2885 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1699781492 |
| NPI Enumeration Date: | 01 Aug, 2006 |
| NPI Last Update On: | 15 May, 2012 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wishbone Enterprises Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | PP414435L | Pennsylvania | Primary | |
| Pharmacist | PP414435L | Pennsylvania | Secondary | |
| Durable Medical Equipment & Medical Supplies | RP032206L | Pennsylvania | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 3962330 | Other | Pennsylvania | Nabp |
| 1007440510001 | Medicaid | Pennsylvania | |
Medicare Enrollment:
Wishbone Enterprises Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 0840490470 | O20120418000145 | Wishbone Enterprises Llc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 279,
Lake Winola, Pennsylvania |
| Zip: | 18625-0279 |
| Phone Number: | 570-378-2885 |
| Fax Number: | 570-378-2962 |
Patients can reach Wishbone Enterprises Llc at
Route 307 Winola Plaza, Lake Winola, Pennsylvania or can
call on customer care at 570-378-2885.
Comments/ Reviews:
Read all the reviews posted for Wishbone Enterprises Llc below. You may also share your own experience with Wishbone Enterprises Llc. Your feedback can help others make better decisions.
**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.