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PASSAVANT DEVELOPMENT CORPORATION NPI 1093291023


NPI Information

NPI: 1093291023
Provider Name: PASSAVANT DEVELOPMENT CORPORATION

Doing Business As: PDC PHARMACY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
1611 PEACH ST STE 400
ERIE, PA
ZIP 16501
Phone: (814) 520-8680
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PASSAVANT DEVELOPMENT CORPORATION is a long term care pharmacy pharmacy in Erie, PA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. PASSAVANT DEVELOPMENT CORPORATION NPI is 1093291023. The provider is registered as an organization entity type.
The provider Is Doing Business As Pdc Pharmacy.

The provider's business location address is:

1611 PEACH ST STE 400
ERIE, PA
ZIP 16501
Phone: (814) 520-8680
Fax: (814) 520-6386

The provider's authorized official is Christina Funkhouser .
The authorized official title is Vp Of Operations and has the following contact phone number (412) 820-1010.

The enumeration date for this NPI number is 7/12/2018 and was last updated on 2/22/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11007303880006MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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