Provider Demographics
NPI:1346395472
Name:GATHAGAN INVESTMENT COMPANY LP
Entity Type:Organization
Organization Name:GATHAGAN INVESTMENT COMPANY LP
Other - Org Name:WOODWARD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GATHAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-378-7648
Mailing Address - Street 1:565 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:HOUTZDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16651-1756
Mailing Address - Country:US
Mailing Address - Phone:814-378-7648
Mailing Address - Fax:814-378-8136
Practice Address - Street 1:565 SPRING ST
Practice Address - Street 2:
Practice Address - City:HOUTZDALE
Practice Address - State:PA
Practice Address - Zip Code:16651-1756
Practice Address - Country:US
Practice Address - Phone:814-378-7648
Practice Address - Fax:814-378-8136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007469960003Medicaid
PA1007469960003Medicaid