Evans City Apothecary and Wellness Center

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PP415497L Issued in PA

Legal business name

EVANS CITY APOTHECARY AND WELLNESS CENTER

Practice address

122 N Washington St
Evans City, PA 16033-1063

Phone

(724) 538-3667

Fax

(724) 538-3826

NPI assigned

Mar 31, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey P Mustovic

Title

Owner Pharmacist

Phone

(724) 538-3667

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720108756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 N WASHINGTON ST",
            "city": "EVANS CITY",
            "state": "PA",
            "postal_code": "160331063",
            "telephone_number": "724-538-3667",
            "fax_number": "724-538-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N WASHINGTON ST",
            "city": "EVANS CITY",
            "state": "PA",
            "postal_code": "160331063",
            "telephone_number": "724-538-3667",
            "fax_number": "724-538-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS CITY APOTHECARY AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUSTOVIC",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "724-538-3667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "PA",
            "license": "PP415497L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Michael Fast, MPT
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• All providers in Evans City, PA
• Compounding Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.