Provider Demographics
NPI:1467344416
Name:FRACKVILLE PHARMACY INC
Entity type:Organization
Organization Name:FRACKVILLE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-655-1900
Mailing Address - Street 1:538 ALTAMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FRACKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17931-2410
Mailing Address - Country:US
Mailing Address - Phone:272-207-2668
Mailing Address - Fax:272-207-2684
Practice Address - Street 1:538 ALTAMONT BLVD
Practice Address - Street 2:
Practice Address - City:FRACKVILLE
Practice Address - State:PA
Practice Address - Zip Code:17931-2410
Practice Address - Country:US
Practice Address - Phone:272-207-2668
Practice Address - Fax:272-207-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy