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MAINLINE COMPOUNDING & INFUSION PHARMACY LLC NPI 1235684952


NPI Information

NPI: 1235684952
Provider Name: MAINLINE COMPOUNDING & INFUSION PHARMACY LLC

Doing Business As: MAINLINE COMPOUNDING & INFUSION PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
1049 SHOEMAKER ST STE 2
NANTY GLO, PA
ZIP 15943
Phone: (814) 419-5031
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MAINLINE COMPOUNDING & INFUSION PHARMACY LLC is a pharmacy in Nanty Glo, PA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. MAINLINE COMPOUNDING & INFUSION PHARMACY LLC NPI is 1235684952. The provider is registered as an organization entity type.
The provider Is Doing Business As Mainline Compounding & Infusion Pharmacy.

The provider's business location address is:

1049 SHOEMAKER ST STE 2
NANTY GLO, PA
ZIP 15943-248
Phone: (814) 419-5031
Fax: (814) 419-5041

The provider's authorized official is Jack Moschgat .
The authorized official title is Pharmd and has the following contact phone number (814) 322-5055.

The enumeration date for this NPI number is 8/23/2016 and was last updated on 3/6/2017.


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
13336H0001XPharmacyHome Infusion Therapy PharmacyNo
23336C0004XPharmacyCompounding PharmacyNo
3333600000XPharmacyPP482669PENNSYLVANIAYes

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
12166206OTHERPK
2103223817-0001MEDICAIDPENNSYLVANIA

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: 4/28/2024

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