Healthcare Provider Details

I. General information

NPI: 1528161114
Provider Name (Legal Business Name): HARRY M MARCHEWKA RPH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MCKEAN AVE
DONORA PA
15033-1003
US

IV. Provider business mailing address

601 MCKEAN AVE
DONORA PA
15033-1003
US

V. Phone/Fax

Practice location:
  • Phone: 724-379-5630
  • Fax: 724-379-6899
Mailing address:
  • Phone: 724-379-5630
  • Fax: 724-379-6899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP412996L
License Number StatePA

VIII. Authorized Official

Name: MR. HARRY MARCHEWKA
Title or Position: RPH, OWNER
Credential: RPH
Phone: 724-379-5630