1316918667 NPI number — WEISSANG, INC.

Table of content: (NPI 1316918667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316918667 NPI number — WEISSANG, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEISSANG, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WHYSONGS PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316918667
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 377
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW PARIS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15554-0377
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-839-9997
Provider Business Mailing Address Fax Number:
814-839-9955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4186 CORTLAND DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW PARIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15554-7706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-839-9997
Provider Business Practice Location Address Fax Number:
814-839-9955
Provider Enumeration Date:
01/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHYSONG
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
814-839-9997

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PP481267 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1016125940001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2086614 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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