Healthcare Provider Details

I. General information

NPI: 1801640842
Provider Name (Legal Business Name): MOPA GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 HOSPITAL RD STE 1100
INDIANA PA
15701-3660
US

IV. Provider business mailing address

841 HOSPITAL RD STE 1100
INDIANA PA
15701-3660
US

V. Phone/Fax

Practice location:
  • Phone: 724-675-8206
  • Fax:
Mailing address:
  • Phone: 724-675-8206
  • Fax:

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 Number
License Number State

VIII. Authorized Official

Name: JOHN PASTOREK
Title or Position: MEMBER OF LLC
Credential: PHARMD
Phone: 724-316-9235