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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