Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Jo Weidenbaum

Individual provider Pharmacist · NPI 1639775240

Mary Jo Weidenbaum is a Pharmacist in Brodheadsville, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2020.

Licensed in
PA
In the registry since
2020

Practice location Partly verified

Some contact details are missing from the federal record.

Cvs Pharmacy Rt 209 And 115
Brodheadsville, PA 18322
Phone: (570) 992-6454
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence RP035615T (PA)

Record details

NPI number1639775240
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 9, 2020
Last updated in NPPESDecember 9, 2020
Certification dateDecember 7, 2020
Mailing addressPo Box 1120, Brodheadsville, PA 18322-1120

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