Healthcare Provider Details

I. General information

NPI: 1891217618
Provider Name (Legal Business Name): HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W CHESTNUT ST STE 200
WASHINGTON PA
15301
US

IV. Provider business mailing address

29 E MAIN ST
GOUVERNEUR NY
13642-1401
US

V. Phone/Fax

Practice location:
  • Phone: 724-223-7710
  • Fax: 724-223-7712
Mailing address:
  • Phone: 315-287-3600
  • Fax: 315-287-4291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DEBRA V BARBER
Title or Position: DIRECTOR OF PBM RELATIONS
Credential:
Phone: 315-287-3600