Martella'S Pharmacy of Windber, LLC

Organization Active NPI Community/Retail Pharmacy · Windber, PA

NPI 1770834137 · NPPES record last updated Feb 20, 2020

Key facts

NPI
1770834137
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
MARTELLA'S PHARMACY OF WINDBER, LLC
Practice address
901 Graham Ave
Windber, PA 15963-1542
Phone
(814) 467-9700
Fax
(814) 467-9777
NPI assigned
Sep 26, 2012
Organization subpart
No

Authorized official

Name
Mr. Jacqueline Martella, R.PH.
Title
Owner
Phone
(814) 629-6624

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20131023001948 PA DME Supplier - Pharmacy 2567697741 Practice locations: Windber, PA
O20131220001347 PA Part B Supplier - Mass Immunization (Roster Biller Only) 2567697741 Practice locations: Windber, PA

National Provider Directory

Tax ID family
Martella'S Pharmacy (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

901 Graham Ave
Windber, PA 15963-1542

Mailing address

901 Graham Ave
Windber, PA 15963-1542
Phone (814) 467-9700

Other providers in Windber, PA

All providers in Windber, PA · Community/Retail Pharmacy in Pennsylvania

Sources for this page

Verify at the official NPI Registry.