Healthcare Provider Details

I. General information

NPI: 1356337828
Provider Name (Legal Business Name): CHOICE FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 S 6TH ST
MCSHERRYSTOWN PA
17344-1800
US

IV. Provider business mailing address

8 S 6TH ST
MCSHERRYSTOWN PA
17344-1800
US

V. Phone/Fax

Practice location:
  • Phone: 717-630-2000
  • Fax: 717-630-8249
Mailing address:
  • Phone: 717-630-2000
  • Fax: 717-630-8249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP415367L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01681374
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier2083743
Identifier TypeOTHER
Identifier State
Identifier IssuerPK

VIII. Authorized Official

Name: ANDREW ALTOBELLI
Title or Position: PRESIDENT
Credential: RPH
Phone: 717-259-8321