Organization
MED-FAST PHARMACY INC
Active
Other names
MED-FAST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BROSKY (BILLING MANAGER)
(724) 378-5325
Entity
Organization
Contact information
Practice address
825 BEAVER GRADE RD, CORAOPOLIS, PA 15108-2639
(412) 262-7979
(412) 262-7957
Mailing address
2003 SHEFFIELD RD, ALIQUIPPA, PA 15001-2758
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP414984L
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007458630034
—
PA
01
—
3969132
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/11/2006
Last updated
01/13/2011
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