Organization
FAMILY APOTHECARY LLC
Active
Other names
The Family Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH CHRISANTHUS (OWNER/PHARMACIST)
(724) 934-2070
Entity
Organization
Contact information
Practice address
10441 PERRY HWY, SUITE 17, WEXFORD, PA 15090-9292
(724) 934-2070
Mailing address
10441 PERRY HWY, SUITE 17, WEXFORD, PA 15090-9292
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PP481790
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022628480001
—
PA
01
—
3992016
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/30/2009
Last updated
04/30/2009
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