Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fayette Physician Network Inc

Organization Non-Pharmacy Dispensing Site · NPI 1053704429

Fayette Physician Network Inc is a Non-Pharmacy Dispensing Site in Masontown, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2015.

Licensed in
PA
In the registry since
2015
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2175 McClellandtown Rd
Masontown, PA 15461-2593
Phone: (724) 583-2819
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence MD417327 (PA)

Record details

NPI number1053704429
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Kenny Heine — Vp Of Operations · (858) 964-1506
Other names Fayette Physician Network-Masontown
NPI enumeratedMarch 10, 2015
Last updated in NPPESMarch 10, 2015
Mailing address5626 Oberlin Dr, Suite 110, San Diego, CA 92121-1705