Healthcare Provider Details

I. General information

NPI: 1750058004
Provider Name (Legal Business Name): SPARTAN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 S PARK RD
BETHEL PARK PA
15102-1150
US

IV. Provider business mailing address

3526 BROWNSVILLE RD
PITTSBURGH PA
15227-3116
US

V. Phone/Fax

Practice location:
  • Phone: 412-831-1333
  • Fax: 412-831-1991
Mailing address:
  • Phone: 412-884-5650
  • Fax: 412-884-5651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ADAM RICE
Title or Position: PRESIDENT
Credential:
Phone: 412-884-5650