Healthcare Provider Details

I. General information

NPI: 1285844787
Provider Name (Legal Business Name): PHARMACY OPERATIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date: 05/28/2008
Reactivation Date: 10/22/2008

III. Provider practice location address

533 GREENVILLE RD
MERCER PA
16137-5019
US

IV. Provider business mailing address

1 RIDER TRAIL PLAZA DRIVE SUITE 300
EARTH CITY MO
63045-1313
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-2240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP410839L
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier0019443030008
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier3988497
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerNCPDP NUMBER

VIII. Authorized Official

Name: DENA FERMAN
Title or Position: THIRD PARTY PLAN COORDINATOR
Credential:
Phone: 314-872-5545