Healthcare Provider Details

I. General information

NPI: 1598094567
Provider Name (Legal Business Name): PHARM ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2009
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 MCLISTER AVE
MINGO JUNCTION OH
43938-1259
US

IV. Provider business mailing address

116 MCLISTER AVE
MINGO JUNCTION OH
43938-1259
US

V. Phone/Fax

Practice location:
  • Phone: 740-535-8068
  • Fax: 740-535-8079
Mailing address:
  • Phone: 740-535-8068
  • Fax: 740-535-8079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRTP.022007350-03
License Number StateOH

VIII. Authorized Official

Name: FRANK VOSTATEK
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 614-886-1673