MEDICARE: ASTI'S WASHINGTON PHARMACY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1457015141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTI'S WASHINGTON PHARMACY, LLC

Provider Business Mailing Address
First Line	:	250 MOUNT LEBANON BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1252
Country	:	US
Telephone Number	:	412-295-3363
Fax Number	:	833-563-2488

Provider Business Practice Location Address
First Line	:	817 JEFFERSON AVE STE 101
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-3822
Country	:	US
Telephone Number	:	412-561-1998
Fax Number	:	833-563-2488

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	SAMANTHA PITZARELLA
Credential	:	PHARM.D.
Telephone Number	:	412-295-3363

Provider Enumeration Date	:	10/28/2021
Last Update Date	:	10/28/2021

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