Healthcare Provider Details

I. General information

NPI: 1639177231
Provider Name (Legal Business Name): AMY J BALOH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WILLOWBROOK PLZ ROUTE 51N
BELLE VERNON PA
15012-4010
US

IV. Provider business mailing address

4510 NORWIN RD
PITTSBURGH PA
15236-1845
US

V. Phone/Fax

Practice location:
  • Phone: 724-379-6000
  • Fax: 724-379-8548
Mailing address:
  • Phone: 412-207-9111
  • Fax: 412-207-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP039993L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: