Organization
MOSHANNON VALLEY PHARMACY INC
Active
Organization
MOSHANNON VALLEY PHARMACY INC
Active
Other names
Moshannon Valley Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MAX FAUST (VICE PRESIDENT / COO)
(814) 684-0230
Entity
Organization
Contact information
Practice address
208 MEDICAL CENTER DR, PHILIPSBURG, PA 16866-1948
(814) 342-3750
(814) 342-6323
Mailing address
208 MEDICAL CENTER DR, PHILIPSBURG, PA 16866-1948
(814) 342-3750
(814) 342-6323
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP411114L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007479930008
—
PA
01
—
2085621
PK
—
Enumeration date
07/26/2006
Last updated
06/15/2020
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