MEDICARE: PASSAVANT DEVELOPMENT CORPORATION

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	3336L0003X	Long Term Care Pharmacy	PP481293	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3982469	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1497824346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSAVANT DEVELOPMENT CORPORATION

Provider Business Mailing Address
First Line	:	100 PASSAVANT WAY
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-1318
Country	:	US
Telephone Number	:	412-820-1010
Fax Number	:	412-820-9157

Provider Business Practice Location Address
First Line	:	2550 EISENHOWER AVE STE B209
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-2331
Country	:	US
Telephone Number	:	484-690-0160
Fax Number	:	484-690-0165

Authorized Official
Title or Position	:	CEO AND PRESIDENT
Name	:	RICK D. SENFT
Credential	:
Telephone Number	:	412-820-1010

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	12/09/2025

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