Provider Demographics
NPI:1902842891
Name:NORTHWEST PHARMACY SOLUTIONS LLC
Entity Type:Organization
Organization Name:NORTHWEST PHARMACY SOLUTIONS LLC
Other - Org Name:NORTHWEST PHARMACY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STEPHENIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-724-3107
Mailing Address - Street 1:740 N MAIN STREET EXT
Mailing Address - Street 2:STE 001
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-1149
Mailing Address - Country:US
Mailing Address - Phone:814-724-3107
Mailing Address - Fax:814-724-3108
Practice Address - Street 1:740 N MAIN STREET EXT
Practice Address - Street 2:STE 001
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-1149
Practice Address - Country:US
Practice Address - Phone:814-724-3107
Practice Address - Fax:814-724-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BN1400X, 333600000X, 3336C0002X, 3336I0012X
PAPP4815193336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014555360001Medicaid
2087503OtherPK
PA5752160001Medicare NSC
PAP00357595Medicare PIN