Mainline Compounding & Infusion Pharmacy

LBN: Mainline Compounding & Infusion Pharmacy Llc
Mainline Compounding & Infusion Pharmacy is an health care organization with primary practice located at 1049 Shoemaker St Ste 2 , Nanty Glo PA 15943-1248. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Mainline Compounding & Infusion Pharmacy Llc can be contacted via phone (814) 419-5031, or through Moschgat, Jack via phone (814) 322-5055.

Contact Information

Primary practice address
1049 Shoemaker St Ste 2 Nanty Glo PA 15943-1248
Phone: (814) 419-5031
Fax: (814) 419-5041
Website:
Map and Directions
Authorized official contact:
Name: Moschgat, Jack
Phone: (814) 322-5055

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PP482669 Pennsylvania
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X

Profile Details

NPI number 1235684952
LBN Legal business name Mainline Compounding & Infusion Pharmacy Llc
DBA Doing business as Mainline Compounding & Infusion Pharmacy
Authorized official Moschgat, Jack
Entity Organization
Organization subpart 1 No
Enumeration date Aug 23rd, 2016
Last updated Mar 6th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235684952 NPPES
Other 2166206 PK
MEDICAID 103223817-0001 PK

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