1730984709 NPI number — LOGAN DAVID MESSNER PHARMD

Table of content: LOGAN DAVID MESSNER PHARMD (NPI 1730984709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730984709 NPI number — LOGAN DAVID MESSNER PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MESSNER
Provider First Name:
LOGAN
Provider Middle Name:
DAVID
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1730984709
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
219 N SHENANGO ST APT B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERCER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16137-1022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-402-6749
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20480 ROUTE 19
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRANBERRY TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16066-7501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-778-8989
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP458343 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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