Provider Demographics
NPI:1306394903
Name:NORTH HUNTINGDON MEDICAL INC
Entity type:Organization
Organization Name:NORTH HUNTINGDON MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACCUSERV PHARMACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-417-9861
Mailing Address - Street 1:8731 ROUTE 30 STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3241
Mailing Address - Country:US
Mailing Address - Phone:866-213-9821
Mailing Address - Fax:877-526-8823
Practice Address - Street 1:8731 STATE ROUTE 30 STE 1
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-3241
Practice Address - Country:US
Practice Address - Phone:866-213-9821
Practice Address - Fax:877-526-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X, 3336S0011X, 333600000X
PAPP4826553336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160599OtherPK