Provider Demographics
NPI:1891794665
Name:FOREST HILLS PHARMACY INC
Entity Type:Organization
Organization Name:FOREST HILLS PHARMACY INC
Other - Org Name:FHP PHARMACY SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LATTANZIO
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:814-495-7127
Mailing Address - Street 1:550 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:PA
Mailing Address - Zip Code:15951-0306
Mailing Address - Country:US
Mailing Address - Phone:814-495-7127
Mailing Address - Fax:814-495-4008
Practice Address - Street 1:550 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:PA
Practice Address - Zip Code:15951-0306
Practice Address - Country:US
Practice Address - Phone:814-495-7127
Practice Address - Fax:814-495-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0397901OtherPACE #
PA1007284790001Medicaid
PA1007284790001Medicaid