Healthcare Provider Details

I. General information

NPI: 1407184807
Provider Name (Legal Business Name): PRIMARY CARE PHARMACY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HECKEL ROAD SUITE 110
MCKEES ROCKS PA
15136
US

IV. Provider business mailing address

27 HECKEL ROAD SUITE 110
MCKEES ROCKS PA
15136
US

V. Phone/Fax

Practice location:
  • Phone: 412-771-2149
  • Fax: 412-771-2169
Mailing address:
  • Phone: 412-771-2149
  • Fax: 412-771-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP481981
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPP481981
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP481981
License Number StatePA

VIII. Authorized Official

Name: MR. ANTHONY F. BERTOLA
Title or Position: PRESIDENT/CEO
Credential: RPH
Phone: 412-583-6332