Provider Demographics
NPI:1457347338
Name:CHRISTOFANO, EDWARD L (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:L
Last Name:CHRISTOFANO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N 4TH ST
Mailing Address - Street 2:D/B/A HAYDENS PHARMACY
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-1558
Mailing Address - Country:US
Mailing Address - Phone:724-925-1400
Mailing Address - Fax:724-925-1430
Practice Address - Street 1:505 N 4TH ST
Practice Address - Street 2:D/B/A HAYDENS PHARMACY
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1558
Practice Address - Country:US
Practice Address - Phone:724-925-1400
Practice Address - Fax:724-925-1430
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI0009321835P0018X
332B00000X, 3336C0004X
PARP437351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy