Healthcare Provider Details

I. General information

NPI: 1316918667
Provider Name (Legal Business Name): WEISSANG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4186 CORTLAND DR
NEW PARIS PA
15554-7706
US

IV. Provider business mailing address

PO BOX 377
NEW PARIS PA
15554-0377
US

V. Phone/Fax

Practice location:
  • Phone: 814-839-9997
  • Fax: 814-839-9955
Mailing address:
  • Phone: 814-839-9997
  • Fax: 814-839-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
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 NumberPP481267
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID WHYSONG
Title or Position: PRESIDENT
Credential:
Phone: 814-839-9997