Active NPI
Med Center Pharmacy
- Community/Retail Pharmacy
- Tyrone, PA
National Provider Identifier
1376664755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MED CENTER PHARMACY
- Practice address
- Cloy Ave Extension
Tyrone, PA 16686 - Phone
- (814) 684-4212
- Fax
- (814) 684-1410
- NPI assigned
- Apr 3, 2007
- Last updated
- Sep 11, 2025
- 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
- Daniel Irvin, RPH
- Title
- Mang
- Phone
- (814) 684-4212
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PP411803L | PA | |
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
Cloy Ave Extension
Tyrone, PA 16686
Mailing address
Cloy Ave Extension
Tyrone, PA 16686
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016864230001 | Medicaid | PA | |
| 3939711 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
National Provider Directory
National Provider Directory- Tax ID family
- Boalsburg Apothecary LTC
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba The Boalsburg Apothecary Inc
- Community/Retail Pharmacy
- Centre Hall, PA
- NPI 1053388470
-
dba Boalsburg Apothecary LTC
- Long Term Care Pharmacy
- Centre Hall, PA
- NPI 1922639012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1376664755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CLOY AVE EXTENSION",
"city": "TYRONE",
"state": "PA",
"postal_code": "16686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CLOY AVE EXTENSION",
"city": "TYRONE",
"state": "PA",
"postal_code": "16686",
"telephone_number": "814-684-4212",
"fax_number": "814-684-1410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MED CENTER PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-03",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "IRVIN",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "MANG",
"authorized_official_telephone_number": "814-684-4212",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "PA",
"license": "PP411803L",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016864230001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3939711",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyrone, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.