MEDICARE: MRS. MADELEINE MARKANTONE RPH

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	183500000X	Pharmacist	RP003965L	PA

General Provider Information

NPI Number	:	1619295722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MADELEINE MARKANTONE RPH

Provider Business Mailing Address
First Line	:	3642 FORBES TRAIL DRIVE
Second Line	:
City	:	MURRYSVILLE
State	:	PA
Zip	:	15668
Country	:	US
Telephone Number	:	412-782-2277
Fax Number	:	412-782-5601

Provider Business Practice Location Address
First Line	:	1125 FREEPORT RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-3103
Country	:	US
Telephone Number	:	412-782-2277
Fax Number	:	412-782-5601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

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