WELLSPAN PHARMACY INC NPI 1689754079

NPI Information

  • NPI: 1689754079
  • Provider Name: WELLSPAN PHARMACY INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: WELLSPAN PHARMACY
  • CLIA Number: 39D0187221
  • Address: 4910 FAIRFIELD RD STE B
    SUITE 2
    FAIRFIELD, PA
    ZIP 17320
  • Phone: (717) 642-8812

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NPI Details

WELLSPAN PHARMACY INC is a community/retail pharmacy pharmacy in Fairfield, PA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. WELLSPAN PHARMACY INC NPI is 1689754079. The provider is registered as an organization entity type.
The provider Is Doing Business As Wellspan Pharmacy.

The provider's business location address is:

4910 FAIRFIELD RD STE B
SUITE 2
FAIRFIELD, PA
ZIP 17320-510
Phone: (717) 642-8812
Fax: (717) 642-6691

The provider's authorized official is Kevin Charnetski .
The authorized official title is Senior Pharmacy Manager and has the following contact phone number (570) 262-6663.

The CLIA number assigned to this NPI record is 39D0187221 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Influenza vaccine split virus, preservative free (HCPCS:90662)

The enumeration date for this NPI number is 10/17/2006 and was last updated on 11/2/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesPP415301LPENNSYLVANIANo
2333600000XPharmacyPP415301LPENNSYLVANIANo
33336C0003XPharmacyCommunity/Retail PharmacyPP415301LPENNSYLVANIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PP415301LOTHERPENNSYLVANIAPHARMACY LICENSE
21007431520005MEDICAIDPENNSYLVANIA
33973282OTHERPENNSYLVANIANABP#

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: 11/21/2025

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