Healthcare Provider Details

I. General information

NPI: 1063187144
Provider Name (Legal Business Name): POLARIS PHARMACY SERVICES OF PENNSYLVANIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CLAIRTON RD
WEST MIFFLIN PA
15122-3010
US

IV. Provider business mailing address

2900 NW 60TH ST
FORT LAUDERDALE FL
33309-1774
US

V. Phone/Fax

Practice location:
  • Phone: 412-655-2151
  • Fax: 412-655-3635
Mailing address:
  • Phone: 800-589-9747
  • Fax: 954-923-9261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID ROMBRO
Title or Position: CEO
Credential:
Phone: 800-589-9747