Healthcare Provider Details

I. General information

NPI: 1578568002
Provider Name (Legal Business Name): THE FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2199 E STATE ST
HERMITAGE PA
16148-2729
US

IV. Provider business mailing address

2199 E STATE ST
HERMITAGE PA
16148-2729
US

V. Phone/Fax

Practice location:
  • Phone: 724-346-4521
  • Fax: 724-346-4523
Mailing address:
  • Phone: 724-346-4521
  • Fax: 724-346-4523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP415568L
License Number StatePA

VIII. Authorized Official

Name: MR. EDWARD CHARLES CLAPPER
Title or Position: PHARMACIST/VICE PRESIDENT
Credential: R.PH
Phone: 724-346-4521