Provider Demographics
NPI:1437453396
Name:CHRISTOFANO ASSOCIATES LLC
Entity Type:Organization
Organization Name:CHRISTOFANO ASSOCIATES LLC
Other - Org Name:HAYDEN'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOFANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-840-2181
Mailing Address - Street 1:2792 STATE ROUTE 982
Mailing Address - Street 2:-CORPORATE OFFICE
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2528
Mailing Address - Country:US
Mailing Address - Phone:724-840-2181
Mailing Address - Fax:724-925-1430
Practice Address - Street 1:505 N 4TH ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1559
Practice Address - Country:US
Practice Address - Phone:724-840-2181
Practice Address - Fax:724-925-1430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336C0004X
PAPP4820883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3994856OtherNCPDP PROVIDER IDENTIFICATION NUMBER