NPIMap

Organization Active NPI

Valentine Pharmacy

  • Community/Retail Pharmacy
  • Fairchance, PA
National Provider Identifier
1144289299
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP481222 Issued in PA
Legal business name
VALENTINE PHARMACY
Practice address
92 N Morgantown St
Fairchance, PA 15436-1038
Phone
(724) 564-1700
Fax
(724) 564-1704
NPI assigned
Mar 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Mangello Mollica, R PH
Title
Owner
Phone
(724) 564-1700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP481222 PA Primary

Addresses

Primary practice location

92 N Morgantown St
Fairchance, PA 15436-1038

Mailing address

92 N Morgantown St
Fairchance, PA 15436-1038

Other identifiers 2

IdentifierTypeStateIssuer
3981645OtherOTHER ID NUMBER
19411230001MedicaidPA

Other names 1

  • VALENTINE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

92 N Morgantown St
Fairchance, PA 15436
Phone (724) 564-1700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1144289299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 N MORGANTOWN ST",
            "city": "FAIRCHANCE",
            "state": "PA",
            "postal_code": "154361038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 N MORGANTOWN ST",
            "city": "FAIRCHANCE",
            "state": "PA",
            "postal_code": "154361038",
            "telephone_number": "724-564-1700",
            "fax_number": "724-564-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENTINE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-18",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "MANGELLO MOLLICA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-564-1700",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3981645",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19411230001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VALENTINE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairchance, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.