Provider Demographics
NPI:1053388470
Name:PHARM-ASSIST INC
Entity type:Organization
Organization Name:PHARM-ASSIST INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-466-7936
Mailing Address - Street 1:1256 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1618
Mailing Address - Country:US
Mailing Address - Phone:814-466-7936
Mailing Address - Fax:814-466-7825
Practice Address - Street 1:2827 EARLYSTOWN RD STE 1
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9108
Practice Address - Country:US
Practice Address - Phone:814-466-7936
Practice Address - Fax:814-466-7825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
PAPP412255L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2173475OtherPK
2144942OtherPK
PAFT3632191OtherDEA
PA4303850001Medicare NSC