FAYETTE PHYSICIAN NETWORK-MASONTOWN
NPI 1053704429
Non-Pharmacy Dispensing Site in Masontown, PA

Active since March 10, 2015
2175 MCCLELLANDTOWN RD, MASONTOWN, PA 15461(724) 583-2819 Get Directions Write a Review

NPPES record last updated: March 10, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fayette Physician Network-masontown NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAYETTE PHYSICIAN NETWORK-MASONTOWN (NPI 1053704429) is a healthcare organization registered as a non-pharmacy dispensing site in Masontown, Pennsylvania and active in the NPI registry since March 2015. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1053704429
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameFAYETTE PHYSICIAN NETWORK INC
Location Address2175 MCCLELLANDTOWN RDMasontown, PA 15461-2593
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateMarch 10, 2015
NPI 1053704429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License Licensed in PA · MD417327
Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

2175 MCCLELLANDTOWN RD, Masontown, PA 15461

Other Names 1

Doing Business AsFayette Physician Network-masontown

Accepted Insurance

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
2175 MCCLELLANDTOWN RD, SUITE 201
MASONTOWN, PA 15461
Family Medicine
2175 MCCLELLANDTOWN RD, SUITE 201
MASONTOWN, PA 15461
Family Medicine
2175 MCCLELLANDTOWN RD
MASONTOWN, PA 15461
Family Medicine
2175 MCCLELLANDTOWN RD, SUITE 201
MASONTOWN, PA 15461

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fayette Physician Network Inc's NPI number?

The NPI number for Fayette Physician Network Inc is 1053704429. It was assigned to this organization in the NPPES registry on March 10, 2015. The provider is doing business as Fayette Physician Network-Masontown.

Where is Fayette Physician Network Inc located?

Fayette Physician Network Inc is located at 2175 Mcclellandtown Rd, Masontown, PA 15461. The listed phone number is (724) 583-2819.

What is Fayette Physician Network Inc's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

What insurance does Fayette Physician Network Inc accept?

Health plans from Sanford Health Plan list Fayette Physician Network Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fayette Physician Network Inc was last updated on March 10, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.