Provider Demographics
NPI:1770659500
Name:NEWHARD PHARMACY INC
Entity Type:Organization
Organization Name:NEWHARD PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-262-6721
Mailing Address - Street 1:1001 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067
Mailing Address - Country:US
Mailing Address - Phone:610-262-6721
Mailing Address - Fax:610-262-7593
Practice Address - Street 1:1001 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067
Practice Address - Country:US
Practice Address - Phone:610-262-6721
Practice Address - Fax:610-262-7593
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEWHARD PHARMACY LTC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-24
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411691L332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3911004OtherNABP#
PA1007473670002Medicaid
PA0326100001Medicare NSC