Your Compounding Pharmacy, LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

YOUR COMPOUNDING PHARMACY, LLC

Doing business as

ADVance Care Pharmacy

Practice address

280 Indian Springs Rd
Suite 125
Indiana, PA 15701-3676

Phone

(724) 463-9300

Fax

(724) 463-9301

NPI assigned

Apr 9, 2007

Last updated

Mar 30, 2023By 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

James Albert KodmanNPI 1548381676

Title

Ceo

Phone

(724) 463-9300

Specialties & licenses 6

Addresses

Other identifiers 3

Other names 1

• ADVance Care Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Albert Kodman, RPH

  • Pharmacist
  • Indiana, PA
  • NPI 1548381676
  NPD Authorized official
• Samantha Auden, PHARMD

  • Pharmacist
  • Indiana, PA
  • NPI 1215708904
  NPD (past)
• Kara Kunselman

  • Pharmacist
  • Indiana, PA
  • NPI 1659095131
  NPD (past)
• Matthew L. Nettleton, MD

  • Internal Medicine Physician
  • Blairsville, PA
  • NPI 1114983616
  NPD (past)
• Paula A. Smulik, PHARM D

  • Pharmacist
  • Indiana, PA
  • NPI 1518508811
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1619090024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 INDIAN SPRINGS RD",
            "address_2": "SUITE 125",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013676",
            "telephone_number": "724-463-9300",
            "fax_number": "724-463-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 INDIAN SPRINGS RD",
            "address_2": "SUITE 125",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013676",
            "telephone_number": "724-463-9300",
            "fax_number": "724-463-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR COMPOUNDING PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "KODMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-463-9300"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP414041L",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "PA",
            "license": "PP414041L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180749",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102834523002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE PHARMACY PERMIT",
            "identifier": "PP414041L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVance Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADVance Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexa Anne Young
• Amelia Luciel Young, BS
• David Thomas Young, D.C.
• Trista Lynn Young, RN
• Charles Andrew Younkin
• Andrew Yourich, OD
• Thomas Richard Yuhas, M.D.
• Zachary Van Yuhas, OD
• Denise Zahorchak, RPH
• Rebecca Ann Zajdel

• Home Infusion Therapy Pharmacy in Indiana, PA
• Providers in Indiana, PA by specialty
• Home Infusion Therapy Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.