Active NPI
Med-Fast Pharmacy Inc
Doing business as Med-Fast Pharmacy
- Community/Retail Pharmacy
- Coraopolis, PA
National Provider Identifier
1174534382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MED-FAST PHARMACY INC
- Doing business as
- Med-Fast Pharmacy
- Practice address
- 825 Beaver Grade Rd
Coraopolis, PA 15108-2639 - Phone
- (412) 262-7979
- Fax
- (412) 262-7957
- NPI assigned
- Aug 11, 2006
- Last updated
- Jan 13, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Brosky
- Title
- Billing Manager
- Phone
- (724) 378-5325
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PP414984L | PA | |
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
825 Beaver Grade Rd
Coraopolis, PA 15108-2639
Mailing address
2003 Sheffield Rd
Aliquippa, PA 15001-2758
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3969132 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 1007458630034 | Medicaid | PA |
Other names 1
- MED-FAST PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Med Fast Pharm Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294876800000",
"number": "1174534382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2003 SHEFFIELD RD",
"city": "ALIQUIPPA",
"state": "PA",
"postal_code": "150012758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 BEAVER GRADE RD",
"city": "CORAOPOLIS",
"state": "PA",
"postal_code": "151082639",
"telephone_number": "412-262-7979",
"fax_number": "412-262-7957"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MED-FAST PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-11",
"last_updated": "2011-01-13",
"status": "A",
"authorized_official_last_name": "BROSKY",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "724-378-5325"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "PA",
"license": "PP414984L",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3969132",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007458630034",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MED-FAST PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Coraopolis, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.