Moshannon Valley Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP412361L Issued in PA

Legal business name

MOSHANNON VALLEY PHARMACY INC

Doing business as

Moshannon Valley Pharmacy

Practice address

402 E Sycamore Rd
Snow Shoe, PA 16874-8832

Phone

(814) 387-4014

Fax

(814) 387-6934

NPI assigned

Jul 26, 2006

Last updated

Jan 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Branstetter

Title

Manager

Phone

(814) 387-4014

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MOSHANNON VALLEY PHARMACY Doing business as

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1508889858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WASHINGTON AVENUE",
            "address_2": "PO BOX 529",
            "city": "HYDE",
            "state": "PA",
            "postal_code": "168430529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E SYCAMORE RD",
            "city": "SNOW SHOE",
            "state": "PA",
            "postal_code": "168748832",
            "telephone_number": "814-387-4014",
            "fax_number": "814-387-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHANNON VALLEY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "BRANSTETTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "814-387-4014"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412361L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007479930009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085757",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOSHANNON VALLEY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia A Butler, CRNP
• Tina Marie Green, CRNP
• Intranerve
• Keystone Rural Health Consortia Inc (Mountaintop Area Medical Center)
• Nathan A Pecht, DMD
• Snow Shoe Ambulance & Rescue Service

• Community/Retail Pharmacy in Snow Shoe, PA
• Providers in Snow Shoe, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.