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
1886 HOMEVILLE RD, WEST MIFFLIN, PA 15122-3650
(412) 346-0220
(412) 346-0222
Mailing address
2003 SHEFFIELD RD, ALIQUIPPA, PA 15001-2758
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP481515
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007458630042
—
PA
01
—
3985073
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
01/13/2011
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