Healthcare Provider Details

I. General information

NPI: 1033959895
Provider Name (Legal Business Name): AZMAJT RETAIL PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N CENTRAL AVE
CANONSBURG PA
15317-1301
US

IV. Provider business mailing address

1 N CENTRAL AVE
CANONSBURG PA
15317-1301
US

V. Phone/Fax

Practice location:
  • Phone: 724-745-6480
  • Fax: 724-916-4957
Mailing address:
  • Phone: 724-745-6480
  • Fax: 724-916-4957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MISS MAGGIE OHARE
Title or Position: OWNER/MANAGER
Credential:
Phone: 412-498-0730