Provider Demographics
NPI:1427422823
Name:CHRISTOFANO ASSOCIATES LLC
Entity type:Organization
Organization Name:CHRISTOFANO ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOFANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-840-2181
Mailing Address - Street 1:2792 STATE ROUE 982
Mailing Address - Street 2:CORPORATE OFFICE
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666
Mailing Address - Country:US
Mailing Address - Phone:724-840-2181
Mailing Address - Fax:724-424-1910
Practice Address - Street 1:3846 PA ROUTE 31
Practice Address - Street 2:
Practice Address - City:DONEGAL
Practice Address - State:PA
Practice Address - Zip Code:15628
Practice Address - Country:US
Practice Address - Phone:724-593-4400
Practice Address - Fax:724-424-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X, 333600000X
PAPP4826543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2155185OtherPK
PA1049812380Medicare NSC