Provider Demographics
NPI:1316015670
Name:PHARM-ASSIST INC
Entity Type:Organization
Organization Name:PHARM-ASSIST INC
Other - Org Name:COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MAX
Authorized Official - Last Name:FAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-684-0230
Mailing Address - Street 1:1256 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1618
Mailing Address - Country:US
Mailing Address - Phone:814-684-0230
Mailing Address - Fax:814-684-0845
Practice Address - Street 1:1256 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1618
Practice Address - Country:US
Practice Address - Phone:814-684-0230
Practice Address - Fax:814-684-0845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-02
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WD0400X
PA6000007948332B00000X
PAPP410763L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005967420002Medicaid
PA0005967420002Medicaid