NPIMap

Organization Active NPI

Moshannon Valley Pharmacy Inc

  • Community/Retail Pharmacy
  • Philipsburg, PA
National Provider Identifier
1487677530
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP411114L Issued in PA
Legal business name
MOSHANNON VALLEY PHARMACY INC
Doing business as
Moshannon Valley Pharmacy Inc
Practice address
208 Medical Center Dr
Philipsburg, PA 16866-1948
Phone
(814) 342-3750
Fax
(814) 342-6323
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Authorized official

Name
William Max Faust
Title
Vice President / Coo
Phone
(814) 684-0230

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP411114L PA Primary

Addresses

Primary practice location

208 Medical Center Dr
Philipsburg, PA 16866-1948

Mailing address

208 Medical Center Dr
Philipsburg, PA 16866-1948
Phone (814) 342-3750

Other identifiers 2

IdentifierTypeStateIssuer
2085621OtherPK
1007479930008MedicaidPA

Other names 1

  • Moshannon Valley Pharmacy Inc Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

208 Medical Center Dr
Philipsburg, PA 16866
Phone (814) 342-3750

1071 N Front St
Philipsburg, PA 16866
Phone (814) 342-3750

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1487677530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MEDICAL CENTER DR",
            "city": "PHILIPSBURG",
            "state": "PA",
            "postal_code": "168661948",
            "telephone_number": "814-342-3750",
            "fax_number": "814-342-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MEDICAL CENTER DR",
            "city": "PHILIPSBURG",
            "state": "PA",
            "postal_code": "168661948",
            "telephone_number": "814-342-3750",
            "fax_number": "814-342-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHANNON VALLEY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "FAUST",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "VICE PRESIDENT / COO",
        "authorized_official_telephone_number": "814-684-0230"
    },
    "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": "PP411114L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085621",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007479930008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moshannon Valley Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moshannon Valley Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philipsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.